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POLICY NUMBER:BA-B9717018-25-N2-G <br />EFFECTIVE DATE:12/07/2025 <br />ISSUE DATE:12/02/2025 <br />LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS <br />THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS <br />BY LINE OF BUSINESS <br />CA F3 02 02 24 BUSINESS AUTO COVER PAGE - PENNSYLVANIA <br />IL TO 02 11 89 COMMON POLICY DECLARATIONS <br />IL T8 01 01 01 FORMS ENDORSEMENTS AND SCHEDULE NUMBERS <br />IL TO 01 08 22 COMMON POLICY CONDITIONS <br />COMMERCIAL AUTO <br />CA TO 01 02 15 BA- COVERAGE PART DECS (ITEMS 1 & 2) <br />CA TO 03 02 15 BUS AUTO COV PART DECLARATIONS-4&5 <br />CA TO 31 02 15 TABLE OF CONTENTS-BUSINESS AUTO COV FORM <br />CA 00 01 10 13 BUSINESS AUTO COVERAGE FORM <br />CA 01 80 03 21 PENNSYLVANIA CHANGES <br />CA 20 54 10 13 EMPLOYEE HIRED AUTOS <br />CA 20 55 10 13 FELLOW EMPLOYEE COVERAGE <br />CA 99 33 10 13 EMPLOYEES AS INSUREDS <br />CA T4 42 02 16 ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH <br /> OTHER INSURANCE <br />CA T4 59 02 15 AMENDMENT OF EMPLOYEE DEFINITION <br />CA T6 44 07 24 LONG TERM LEASED AUTOS COVERED AS OWNED AUTOS <br />CA T3 40 02 15 BLANKET WAIVER OF SUBROGATION <br />CA T5 20 02 15 LEASED AUTOS EXCLUSION <br />CA T5 23 02 19 EXCLUSION - PORTFOLIO COMPANY <br />INTERLINE ENDORSEMENTS <br />IL T3 20 05 19 NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US <br />IL T4 12 03 15 AMNDT COMMON POLICY COND-PROHIBITED COVG <br />IL 00 21 09 08 NUCLEAR ENERGY LIABILITY EXCLUSION <br />ENDORSEMENT (BROAD <br />IL 02 46 09 07 <br />FORM) <br />PENNSYLVANIA CHANGES - CANCELLATION AND NONRENEWAL <br />IL 09 10 07 02 PENNSYLVANIA NOTICE <br />IL T8 01 01 01 PAGE:1 OF 1 <br />Attachment Code: D681956 Master ID: 1529369, Certificate ID: 19861348 <br />Docusign Envelope ID: 458D6D02-0D6B-8C4E-8292-D706A4D93B4D