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* S1 * 02/02/2024 * GLP 0482161 11 GREAT AMERICAN ASSURANCE COMPANY <br /> *D/B* 397946331 694948 <br /> IL 73 68 (Ed. 01/20) <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 /> Schedule <br /> Schedule - Part I <br /> Terrorism Premium (Certified Acts) $ 0 . 00 <br /> This premium is the total Certified Acts premium attributable to the following Coverage Part(s), Coverage Form(s) <br /> and/or Policy(ies): GLP 048- 21 - 61 - 11 <br /> Additional information, if any, concerning the terrorism premium: <br /> Schedule - Part II <br /> Federal share of terrorism losses is 80% <br /> (Refer to Paragraph B. in this endorsement.) <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 /> Includes copyrighted material of Insurance Services Office, Inc., with its permission <br /> IL 73 68 (Ed. 01/20) (Page 1 of 2) <br />