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* 081 * 06/07/2021 * UMB 3952752 00 GREAT AMERICAN ALLIANCE INS CO <br />*D/B* 121126296 255044 <br />GAI 6472 (Ed. 04/15) <br />THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN <br />RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK <br />INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR <br />CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. <br />DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL UMBRELLA <br />EXCESS LIABILITY <br />Schedule* <br />Terrorism Premium (Certified Acts) $ 0. 00 <br />* Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Disclosure Of Premium <br />In accordance with the federal Terrorism Risk Insurance Act, we are required to provide you with a notice <br />disclosing the portion of your premium, if any, attributable to coverage for terrorist acts certified under the <br />Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the <br />Schedule of this endorsement or in the policy Declarations. <br />B. Disclosure Of Federal Participation In Payment Of Terrorism Losses <br />The United States Government, Department of the Treasury, will pay a share of terrorism losses insured <br />under the federal program. The federal share equals a percentage (as shown in paragraph D. below) of that <br />portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if <br />aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed <br />$100 billion in a calendar year the Treasury shall not make any payment for any portion of the amount of such <br />losses that exceeds $100 billion. <br />C. Cap On Insurer Participation In Payment Of Terrorism Losses <br />If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act <br />exceed $100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk <br />Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that <br />exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rate allocation in <br />accordance with procedures established by the Secretary of the Treasury. <br />D. Federal Share of Losses Under the Terrorism Risk Insurance Act <br />85% Year: 2015 <br />84% Year: 2016 <br />83% Year: 2017 <br />82% Year: 2018 <br />81% Year: 2019 <br />80% Year: 2020 <br />This endorsement does not change any other provision of the policy. <br />Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />GAI 6472 (Ed. 04/15) (Page 1 of 1) <br />