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H I SCOX HISCOX INSURANCE COMPANY INC. (A Stock Company) <br />encourage courage 104 South Michigan Avenue, suite 600. Chicago, Illinois60603 <br />Forms and Endorsements Schedule <br />Forms and Endorsements made part of this policy at time of issue: <br />CGL D001 01 10 - Commercial General Liability Declarations <br />CG 00 01 12 07 - General Liability Coverage Form <br />CGL E5421 CW (02/14) - Additional Insured - Automatic Status <br />CGL E5581 CW (03/16) - Primary and Noricontributory - Other Insurance Condition <br />CGL E5409 CW (03/10) - Right and Duty to Select Defense Counsel <br />CGL E5404 CW (03/10) - Exclusion - Personal Information <br />CGL E5408 CW (03/10) - Cancellation Provision (14 Day Full Refund) <br />CGL E5403 CW (03/10) - Notice Information <br />CGL E5401 CW (03/10) - Definition of Employee <br />CGL E5407 CW (03110) - Exclusion - Professional Services <br />IL 00 2109 08 - Nuclear Energy Liability Exclusion Endorsement (Broad Form) <br />IL 02 70 09 08 - California Changes - Cancellation and Nonrenewal <br />CG 32 34 0105 - California Changes <br />IL 001711 98 - Common Policy Conditions <br />CG 2141 1185 - Exclusion - Intercompany Products Suits <br />CG 00 68 05 09 - Recording and Distribution of Material or Information in Violation of Law Exclusion <br />CG 2173 01 15 - Exclusion Of Certified Acts Of Terrorism <br />CGL E5402 CW (03/10) - Modified Waiver of Transfer of Rights of Recovery Against Others To Us <br />INT N001 CW (01/09) - Economic And Trade Sanctions Policyholder Notice <br />INT D001 01 10 <br />RItkMwv9a dDWim <br />REVIEWED & APPROVED Or. <br />��' Risk Management Analyst <br />