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Philadelphia Indemnity Insurance Company <br />Form Schedule — Commercial Auto <br />Policy Number: PHPK2635616 <br />Forms and Endorsements applying to this Coverage Part and made a part of this <br />policy at time of issue - <br />Form Edition Description <br />IL N 119 <br />1015 <br />California Auto Body Repair Consumer Bill Of Rights <br />PI-CA-AD-CDEX-NOTICE 1 <br />0121 <br />Advisory Notice To Policyholders -Notice of Red in Cov <br />CADS03 <br />0310 <br />Business Auto Declarations <br />Auto Schedule <br />0100 <br />Business Auto Schedule <br />CA0001 <br />0310 <br />Business Auto Coverage Form <br />CA0143 <br />0507 <br />California Changes <br />CA0424 <br />0406 <br />California Auto Medical Payments Coverage <br />CA2155 <br />0610 <br />California Uninsured Motorists Cov-Property Damage <br />PI-AUT-001 <br />0116 <br />Cap On Losses From Certified Acts Of Terrorism <br />PI-CA-032 CA <br />0521 <br />California Uninsured Motorists Coverage -Bodily Injury <br />F Risk Mougement D'Mslcrn <br />%x REVIEWE<7&PaPPROVmBY: <br />— Risk Management Specialist <br />Page 1 of 1 <br />