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DocuSign Envelope ID: D81 132DAD-599E-4763-A300-356131341`41 E65 <br /> ,.�7 <br /> %—a NMI = AMN I v <br /> `�J Insurance Companies BOP 2630684 03 <br /> FORMS AND ENDORSEMENTS <br /> APPLICABLE TO THE COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> NEW FORM OR ENDORSEMENT ENDORSEMENT TITLE <br /> AND EDITION DATE (Only the endorsement titles are shown below, please review the <br /> form for a complete description of coverage.) <br /> CG 21 67 12 04 Fungi or Bacteria Exclusion <br /> SL 00 62 01 08 Broad Form Notice of Occurrence <br /> SL 00 63 01 08 Liability Extension Endorsement <br /> SL 00 64 01 08 Incidental Medical Services Liability <br /> SL 20 02 01 06 Asbestos Exclusion <br /> SL 20 04 01 06 Exclusion-Lead Liability <br /> SL 21 16 01 08 Professional Liability Exclusion <br /> CG 00 01 12 04 Commercial General Liability Coverage Form <br /> CG 24 26 07 04 Amendment of Insured Contract Definition <br /> CG 2147 07 98 Employment Related Practices Exclusion <br /> CG 21 70 01 08 Cap on Losses From Certified Acts of Terrorism <br /> CG 21 76 01 08 Exclusion of Punitive Damages Related to a Certified Act of <br /> Terrorism <br /> SL 11 73 12 11 Waiver of Transfer of Rights of Recovery Against Others to Us- <br /> Automatic <br /> CG 00 67 05 09 Recording and Distribution of Material or Information in <br /> Violation of Law <br /> CG 25 04 03 97 Designated Location(s)General Aggregate Limit <br /> IL 00 2109 08 Nuclear Energy Exclusion <br /> CG 32 24 06 10 Colorado Changes-Amendment of Insured Contract Definition <br /> SL 20 51 12 11 Amendment of Contractual Liability Exclusion <br /> SL 20 38 01 13 Additional Insured-Owners, Lessees, or Lessors of Leased <br /> Equipment-Automatic <br /> SL 10 23 12 09 Additional Insured-Owners, Lessees, Contr- Incl Completed <br /> Ops-Scheduled <br /> CG 21 87 01 07 Conditional Exclusion of Terrorism <br /> IL 09 99 0107 Disclosure of Premium and Estimated Premium for Certified Acts of <br /> Terrorism Coverage <br /> `Indicates a new form has been added or a replacement form has been substituted for one of an earlier <br /> edition. Please retain all forms. <br /> Issue Date 06/11/2014 01:59:45 PM BP 60 02 (01108) Page 005 of 007 <br /> 0001001 P,W.d: <br />