FARM PERSONAL LIABILITY/PERSONAL LIABILITY …

1 farm PERSONAL LIABILITY / PERSONAL LIABILITY FORMS IA, MN, NE, ND, OK, SD, WI INCLUDING DWELLING LIABILITY AND COMMERCIAL LIABILITY ( farm PREMISES AND OPERATIONS) The alphabetical key listed below shows the letter designation assigned to each line of insurance. These letters are listed under the column titled PROG. USED IN to show which lines of business each form is used in. O = Dwelling LIABILITY (NS-800) W = farm PERSONAL LIABILITY (NS-710) V = PERSONAL LIABILITY (NS-700) 1 = Commercial LIABILITY ( farm Premises and Operations) (NS-810) form NUMBERS PROG. & EDITION DATES COMP. USED IN TITLE 8TL 01-15 MAFMIC OW1 CERTIFIED TERRORISM LOSS COVERAGE/NON-CERTIFIED TERRORISM LOSS EXCLUSION/NUCLEAR, BIOLOGICAL, CHEMICAL AND RADIOLOGICAL EXCLUSION/WAR AND MILITARY ACTION EXCLUSION (MN use with CPP only) PDN-8TL 1-15 MAFMIC OW1 POLICYHOLDER DISCLOSURE NOTICE NOTICE OF TERRORISM INSURANCE (MN use with CPP only) GL-40 AAIS W1 STRUCTURES RENTED TO OTHERS FL-42 09-98 NSM VW OFFICE, PROFESSIONAL, PRIVATE SCHOOL, OR STUDIO OCCUPANCY NS-42A 10-89 NSM VW OFFICE PROFESSIONAL, PRIVATE SCHOOL, OR STUDIO OCCUPANCY (MN - use with CPP only)

2 FL-46 04-15 NSM VW PERSONAL INJURY GL-70 AAIS VW ADDITIONAL INSURED PERSONS OR ORGANIZATIONS NS-70 04-98 NSM VW 1 ADDITIONAL RESIDENTIAL PREMISES RENTED TO OTHERS - LIABILITY COVERAGE ONLY NS-71 04-98 NSM VW BUSINESS ACTIVITIES GL-72 AAIS VW ADDITIONAL INSUREDS (RESIDENT OF YOUR HOUSEHOLD) NS-75 04-98 NSM VW WATERCRAFT LIABILITY COVERAGE ONLY GL-90 AAIS VW INCIDENTAL BUSINESS PURSUITS FL-108 09-98 NSM 1 ADDITIONAL INSUREDS (Applies to Commercial LIABILITY Coverage farm Premises and Operations) CF-112 02-18 NSM W farm PERSONAL LIABILITY APPLICATION (IA,MN,NE,ND,SD,WI) DF-141 01-04 NSM VW ADDITIONAL INSURED (Used only with a Dwelling Fire Policy) FL-157 09-98 NSM VW CARE PROVIDED FOR OTHERS (IA,NE,ND,OK,SD,WI) NS-157A 10-89 NSM VW CARE PROVIDED FOR OTHERS (MN - use with CPP only) FL-157M 09-98 NSM VW CARE PROVIDED FOR OTHERS (MN) NS-164 04-98 NSM VW RECREATIONAL MOTOR VEHICLE LIABILITY LIABILITY COVERAGE ONLY ML-209 AAIS VW WATERBED LIABILITY CL-300 AAIS OVW1 AMENDATORY ENDORSEMENT (MN use with CPP only) (IA,NE,ND,SD,WI use with FO/FF only) FL-313 05-10 NSM 1 CUSTOM farm WORK (Applies to Commercial LIABILITY Coverage farm Premises and Operations) NS-315A 07-88 NSM VW ADDITIONAL INSURED (MN use with CPP only) FL-316 09-98 NSM W ADDITIONAL INSURED - PARTNERSHIP NS-316A 07-88 NSM W ADDITIONAL INSURED PARTNERSHIP (MN use with CPP only)

3 ML-416 AAIS VW ADDITIONAL INSURED - LANDLORD NS-423 04-98 NSM W1 FRUIT OR VEGETABLE PICKING BY PUBLIC AND HORSE BOARDING OPERATIONS NS-432 04-98 NSM VW GOLF CART LIABILITY FL-506 09-98 NSM W CORPORATION AS NAMED INSURED NS-506A 01-18 NSM W CORPORATION AS NAMED INSURED (MN use with CPP only) NS-507 04-98 NSM W FARMER S MEDICAL PAYMENTS CF-519 02-18 NSM V PERSONAL LIABILITY APPLICATION (IA,MN,NE,ND,SD,WI) FL-553 09-98 NSM W ANIMAL COLLISION NS-700 09-98 NSM V PERSONAL LIABILITY COVERAGE NS-704 04-98 NSM VW RECREATIONAL MOTOR VEHICLE LIABILITY LIABILITY COVERAGE ONLY NS-710 09-98 NSM W PERSONAL LIABILITY COVERAGE ( farm ) NS-800 09-98 NSM O DWELLING LIABILITY COVERAGE (PREMISES ONLY) farm PERSONAL LIABILITY / PERSONAL LIABILITY FORMS IA, MN, NE, ND, OK, SD, WI INCLUDING DWELLING LIABILITY AND COMMERCIAL LIABILITY ( farm PREMISES AND OPERATIONS) The alphabetical key listed below shows the letter designation assigned to each line of insurance.

4 These letters are listed under the column titled PROG. USED IN to show which lines of business each form is used in. O = Dwelling LIABILITY (NS-800) W = farm PERSONAL LIABILITY (NS-710) V = PERSONAL LIABILITY (NS-700) 1 = Commercial LIABILITY ( farm Premises and Operations) (NS-810) form NUMBERS PROG. & EDITION DATES COMP. USED IN TITLE NS-810 09-98 NSM 1 COMMERCIAL LIABILITY COVERAGE ( farm PREMISES AND OPERATIONS) CF-842 07-15 NSM OVW1 CONTRACT EXPLANATION (attach only when LIABILITY is written with Property coverage) FL-872 09-98 NSM 1 farm EMPLOYERS LIABILITY COVERAGE (Applies to Commercial LIABILITY Coverage farm Premises and Operations) FL-904 04-15 NSM 1 PERSONAL INJURY AND ADVERTISING INJURY LIABILITY COVERAGE (Applies to Commercial LIABILITY Coverage farm Premises and Operations) CF-926 04-15 NSM O1 AMENDATORY ENDORSEMENT (MN) CF-927 07-15 NSM O1 AMENDATORY ENDORSEMENT (SD) CF-928 05-18 NSM O1 AMENDATORY ENDORSEMENT (ND) CF-929 07-15 NSM O1 AMENDATORY ENDORSEMENT (OK)

5 CF-932 03-17 NSM VW PERSONAL LIABILITY COVER SHEET DF-987 01-04 NSM O ADDITIONAL INSURED (Used only with a Dwelling Fire Policy.) CF-1031 07-15 NSM O1 AMENDATORY ENDORSEMENT (NE) NSCF-1243 08-11 NSM OVW1 NOTICE CONCERNING POLICYHOLDERS RIGHTS IN AN INSOLVENCY UNDER THE MINNESOTA INSURANCE GUARANTY ASSOCIATION LAW (MN) (This notice must be given with the application. The notice must be given in writing or in the same medium as the application for insurance. This notice would only be attached to renewal certificates if the renewal increases the dollar amount of a coverage by more than 100%.) (The NSCF-1243 will not show on the dec.!) CF-1269 09-98 NSM O ADDITIONAL INSURED CF-1318 05-18 NSM W AMENDATORY ENDORSEMENT- PERSONAL LIABILITY COVERAGE (ND) CF-1355 05-18 NSM V AMENDATORY ENDORSEMENT- PERSONAL LIABILITY COVERAGE (ND) CF-1356 05-18 NSM VW AMENDATORY ENDORSEMENT- PERSONAL LIABILITY COVERAGE (SD) CF-1366 10-93 NSM OVW1 OKLAHOMA NOTICE (OK) CF-1379 06-94 NSM NOTICE TO POLICYHOLDERS (Do not show form number or edition date on Declarations.)

6 Use to notify policyholder that PERSONAL Injury has been added to avoid a gap in coverage on their Umbrella LIABILITY Policy.) CF-1415 04-18 NSM VW AMENDATORY ENDORSEMENT- PERSONAL LIABILITY COVERAGE (MN) CF-1419 01-11 NMS VW UNINSURED AND UNDERINSURED MOTORISTS COVERAGE (SD) (Applies to Licensed ATVs and/or Snowmobiles CF-1440 05-18 NSM VW AMENDATORY ENDORSEMENT- PERSONAL LIABILITY COVERAGE (NE) FL-1526 04-15 NSM O PERSONAL INJURY AND ADVERTISING INJURY LIABILITY COVERAGE (Applies to Dwelling LIABILITY Coverage) FL-1638 01-08 NSM 1 farm POLLUTION AND CLEAN UP COVERAGE (Applies to Commercial LIABILITY Coverage farm Premises and Operations) CF-1671 09-99 NSM W PROPERTY DAMAGE DEDUCTIBLE INSURANCE CF-1672 09-99 NSM 1 PROPERTY DAMAGE DEDUCTIBLE INSURANCE CF-1691 05-18 NSM VW AMENDATORY ENDORSEMENT- PERSONAL LIABILITY COVERAGE (OK)

7 CF-1736 01-15 NSM OW1 CERTIFIED TERRORISM LOSS COVERAGE; NON-CERTIFIED TERRORISM LOSS EXCLUSION; NUCLEAR, BIOLOGICAL, CHEMICAL AND RADIOLOGICAL EXCLUSION; WAR AND MILITARY ACTION EXCLUSION (MN CPP use 8TL)(MN,NE,ND,SD) CF-1847 03-17 NSM O1 COMMERCIAL LIABILITY COVER SHEET CF-1849 12-10 NSM VW LICENSED RECREATIONAL MOTOR VEHICLE LIABILITY LIABILITY COVERAGE ONLY CF-1850 05-06 NSM W DEFINITION OF INSURED ENDORSEMENT CF-1878 02-18 NSM W NS-800/NS-810 APPLICATION (PREMISES/ farm PREMISES AND OPERATIONS LIABILITY (IA,MN,NE,ND,SD,WI) CF-1895 01-15 NSM OW1 NOTICE OF TERRORISM INSURANCE (MN, NE, ND, SD) farm PERSONAL LIABILITY / PERSONAL LIABILITY FORMS IA, MN, NE, ND, OK, SD, WI INCLUDING DWELLING LIABILITY AND COMMERCIAL LIABILITY ( farm PREMISES AND OPERATIONS) The alphabetical key listed below shows the letter designation assigned to each line of insurance.)

8 These letters are listed under the column titled PROG. USED IN to show which lines of business each form is used in. O = Dwelling LIABILITY (NS-800) W = farm PERSONAL LIABILITY (NS-710) V = PERSONAL LIABILITY (NS-700) 1 = Commercial LIABILITY ( farm Premises and Operations) (NS-810) form NUMBERS PROG. & EDITION DATES COMP. USED IN TITLE CF-1897 01-15 NSM OW1 CERTIFIED TERRORISM LOSS COVERAGE; NON-CERTIFIED TERRORISM LOSS EXCLUSION (WITH LIMITED EXCEPTION); NUCLEAR, BIOLOGICAL, CHEMICAL AND RADIOLOGICAL EXCLUSION; WAR AND MILITARY ACTION EXCLUSION (IA, WI) CF-1898 01-15 NSM OW1 NOTICE OF TERRORISM INSURANCE (IA, WI) CF-1916 05-18 NSM VW AMENDATORY ENDORSEMENT PERSONAL LIABLITY COVERAGE (IA) CF-1917 07-15 NSM O1 AMENDATORY ENDORSEMENT (IA) CF-1942 02-09 NSM W farm PERSONAL LIABILITY APPLICATION (OK) CF-1943 02-09 NSM V PERSONAL LIABILITY APPLICATION (OK) CF-1944 01-16 NSM 1 NS-810 APPLICATION ( farm PREMISES AND OPERATIONS LIABILITY ) (OK) CF-1967 05-10 NSM VW CUSTOM farm WORK (Applies to PERSONAL / farm PERSONAL LIABILITY Coverage)

9 CF-2026 06-12 NSM W CONTRACT GROWERS LIMITED LIABILITY COVERAGE CF-2082 04-14 NSM W SPRAY DRIFT FROM AGRICULTURAL CUSTOM SPRAYING CF-2097 04-15 NSM VWO1 NOTICE TO POLICYHOLDERS CF-2142 05-16 NSM OW1 ADDITIONAL INSURED LIMITED (POWER COMPANY OR COOPERATIVE) CF-2173 01-18 NSM O1 AMENDATORY ENDORSEMENT (WI) CF-2174 05-18 NSM VW AMENDATORY ENDORSEMENT PERSONAL LIABILITY COVERAGE (WI)