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DocuSign Envelope ID:8C7A270E-432E-42E0-A5B7-5136E53010EC <br /> Forms Schedule — General Liability <br /> Policy Number: PHPK1542474-000 <br /> Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: <br /> Form/Edition Description <br /> CG 00 01 12 07 Commercial General Liability Coverage Form <br /> Commercial General Liability GL Coverage Part Declarations Page <br /> Coverage Part Declarations <br /> Commercial GL Supplemental Commercial GL Coverage Supplemental Schedule <br /> Schedule <br /> PI-APG-004 (01/07) Additional Conditions <br /> PI-APG-NC-1 (01/07) North Carolina Amendatory-Cancel, Nonrenew and Cond. Renewal <br /> PI-BELL-1 11-09 Bell Endorsement <br /> PI-FW-001 (01/07) Coverage C-Athletic Activities Exclusion Deletion <br /> PI-FW-002 (03/09) Fitness and Wellness Liability Insurance Exclusions <br /> PI-FW-003 (01/07) Fitness and Wellness Liability Insurance Extension <br /> PI-FW-005 (01/07) Punitive Damages Exclusion <br /> PI-FW-006 (01/07) Sexual Abuse Endorsement <br /> PI-FW-007 (01/07) Specific Claimant Exclusion <br /> PI-FW-008 (01/07) Violation of Communication or Information Law Exclusion <br /> PI-FW-009 (06/11) Blanket Additional Insured <br /> Page 1 of 1 <br />