AMENDMENT NO. 1 TO DISTRIBUTION AGREEMENT
The DISTRIBUTION AGREEMENT ("Agreement") by and between COMMONWEALTH ANNUITY AND
LIFE INSURANCE COMPANY ("Insurer"), for itself and on behalf of each of its
Separate Accounts, and SECURITY DISTRIBUTORS, INC. ("SDI"), dated November 21,
2006, is hereby amended as follows:
WHEREAS, pursuant to the Agreement, SDI serves as principal underwriter of the
Contracts issued by Insurer and listed on Schedule 2 of the Agreement; and
WHEREAS, Insurer wishes to have its affiliate, Epoch Securities, Inc. ("Epoch"),
a broker-dealer registered with the Securities and Exchange Commission, become
principal underwriter for certain of the Contracts.
1. The parties agree that from and after the effective date of this Amendment
No. 1, SDI shall no longer be the principal underwriter for the Contracts
("Removed Insurance Contracts") set forth in Schedule 3, attached hereto.
2. Insurer represents and warrants that, as of the effective date of this
Amendment No. 1, it has entered into a distribution agreement with Epoch with
respect to the Removed Insurance Contracts set forth in Schedule 3.
3. Schedule 1 and Schedule 2 of the Agreement are hereby deleted in their
entirety and replaced with the Schedule 1 and Schedule 2, respectively, attached
hereto.
4. All other terms and provisions of the Agreement not amended herein shall
remain in full force and effect.
5. This Amendment No. 1 is effective as of January 22, 2008.
SECURITY DISTRIBUTORS, INC.
By: /s/ Xxxxx X. Xxxxxxx
---------------------------------
(Print) Xxxxx X. Xxxxxxx
Title: Vice President
Date: January 22, 2008
COMMONWEALTH ANNUITY AND LIFE INSURANCE COMPANY
By: /s/ Xxxxxxx X. Xxxxxxx
----------------------------------------
(Print) Xxxxxxx X. Xxxxxxx
Title: President and Chief Executive Officer
Date: January 22, 2008
1
SCHEDULE 1
SEPARATE ACCOUNTS AVAILABLE UNDER THE CONTRACTS
SELECT SEPARATE ACCOUNT II
XXXXXXX XXXXX VARIABLE INSURANCE TRUST (SERVICE SHARES)
Xxxxxxx Sachs Capital Growth Fund
Xxxxxxx Xxxxx Core Fixed Income Fund
Xxxxxxx Sachs Equity Index Fund
Xxxxxxx Xxxxx Growth Opportunities Fund
Xxxxxxx Sachs Mid Cap Value Fund
Xxxxxxx Xxxxx Money Market Fund
Xxxxxxx Sachs Strategic International Equity Fund
AIM VARIABLE INSURANCE FUNDS (SERIES I SHARES)
AIM V.I. Capital Appreciation Fund
AIM V.I. Global Health Care Fund
ALLIANCEBERNSTEIN VARIABLE PRODUCTS SERIES FUND, INC. (CLASS B)
AllianceBernstein Growth and Income Portfolio
AllianceBernstein Large Cap Growth Portfolio
FIDELITY VARIABLE INSURANCE PRODUCTS FUNDS
Fidelity VIP Equity-Income Portfolio
Fidelity VIP Growth Portfolio
Fidelity VIP High Income Portfolio
FRANKLIN XXXXXXXXX VARIABLE INSURANCE PRODUCTS TRUST (CLASS 2)
FT VIP Franklin Small-Mid Cap Growth Securities Fund
FT VIP Mutual Shares Securities Fund
JANUS ASPEN SERIES (SERVICE SHARES)
Janus Aspen Large Cap Growth Portfolio
X. XXXX PRICE INTERNATIONAL SERIES, INC.
X. Xxxx Price International Stock Portfolio
2
SEPARATE ACCOUNT FUVUL
XXXXXXX XXXXX VARIABLE INSURANCE TRUST (SERVICE SHARES)
Xxxxxxx Sachs Money Market Fund*
AIM VARIABLE INSURANCE FUNDS (SERIES I SHARES)
AIM V.I. Capital Appreciation Fund
AIM V.I. Core Equity Fund
XXXXX AMERICAN FUND (CLASS O)
Xxxxx American Growth Portfolio
DREYFUS VARIABLE INVESTMENT FUND
Dreyfus VIF Quality Bond Portfolio*
FEDERATED INSURANCE SERIES
Federated American Leaders Fund II*
Federated High Income Bond Fund II*
FRANKLIN XXXXXXXXX VARIABLE INSURANCE PRODUCTS TRUST (CLASS 2)
FT VIP Xxxxxxxxx Foreign Securities Fund*
MFS(R) VARIABLE INSURANCE TRUST(SM) (SERVICE SHARES)
MFS(R) Utilities SerieS
XXXXXXXXXXX VARIABLE ACCOUNT FUNDS (SERVICE SHARES)
Xxxxxxxxxxx Main Street Fund(R)/VA
* As of December 30, 2006, fund has zero-balance, but open to new money.
(1) As of September 30, 2004, the following funds were closed to new money and
transfers and have zero balance.
Xxxxx American Leveraged AllCap Portfolio
Alger American Small Capitalization Portfolio
Dreyfus VIF Appreciation Portfolio
Dreyfus Socially Responsible Growth Fund, Inc.
Evergreen VA Balanced (b) Fund (formerly Evergreen Foundation Fund)
Evergreen VA Special Values Fund (formerly Evergreen VA Small Cap Value Fund)
Federated Prime Money Fund II
FT VIP Templeton Global Asset Allocation Fund
MFS(R) Investors Trust Series
Xxxxxxxxxxx Core Bond Fund/VA (formerly Xxxxxxxxxxx Strategic Bond Fund/VA)
Xxxxxxxxxxx Main Street Small Cap Fund(R)/VA
3
SEPARATE ACCOUNT KGC
AIM VARIABLE INSURANCE FUNDS
(SERIES I SHARES)
AIM V.I. Utilities Fund
ALGER AMERICAN FUND (CLASS O)
Xxxxx American Balanced Portfolio
Alger American Leveraged AllCap Portfolio
CREDIT SUISSE TRUST
Credit Suisse Trust Emerging Markets Portfolio
Credit Suisse Trust Global Small Cap Portfolio
DREYFUS INVESTMENT PORTFOLIO
Dreyfus IP MidCap Stock Portfolio
DREYFUS SOCIALLY RESPONSIBLE GROWTH FUND, INC.
Dreyfus Socially Responsible Growth Fund, Inc.
DWS XXXXXXX INVESTMENT VIT FUNDS (CLASS A)
DWS Equity 500 Index VIP
DWS VARIABLE SERIES I (CLASS A)
DWS Capital Growth VIP*
DWS Global Opportunities VIP
DWS Growth & Income VIP*
DWS Health Care VIP
DWS International VIP
DWS VARIABLE SERIES II (CLASS A)
DWS Balanced VIP
DWS Blue Chip VIP
DWS Core Fixed Income VIP
DWS Xxxxx Venture Value VIP
DWS Dreman High Return Equity VIP*
DWS Dreman Small Mid Cap Value VIP
DWS Global Thematic VIP
DWS Government & Agency Securities VIP
DWS High Income VIP
DWS International Select Equity VIP
DWS Janus Growth and Income VIP
DWS Large Cap Value VIP
DWS Mid Cap Growth VIP
DWS Money Market VIP
DWS Small Cap Growth VIP*
DWS Strategic Income VIP
DWS Technology VIP
DWS Xxxxxx Mid Cap Growth VIP
SEPARATE ACCOUNT KG
AIM VARIABLE INSURANCE FUNDS
(SERIES I SHARES)
AIM V.I. Utilities Fund
ALGER AMERICAN FUND (CLASS O)
Xxxxx American Balanced Portfolio
Alger American Leveraged AllCap Portfolio
CREDIT SUISSE TRUST
Credit Suisse Trust Emerging Markets Portfolio
Credit Suisse Trust Global Small Cap Portfolio
DREYFUS INVESTMENT PORTFOLIO
Dreyfus IP MidCap Stock Portfolio
DREYFUS SOCIALLY RESPONSIBLE GROWTH FUND, INC.
Dreyfus Socially Responsible Growth Fund, Inc.
DWS XXXXXXX INVESTMENT VIT FUNDS (CLASS A)
DWS Equity 500 Index VIP
DWS VARIABLE SERIES I (CLASS A)
DWS Capital Growth VIP*
DWS Global Opportunities VIP
DWS Growth & Income VIP*
DWS Health Care VIP
DWS International VIP
DWS VARIABLE SERIES II (CLASS A)
DWS Balanced VIP
DWS Blue Chip VIP
DWS Core Fixed Income VIP
DWS Xxxxx Venture Value VIP
DWS Dreman High Return Equity VIP
DWS Dreman Small Mid Cap Value VIP
DWS Global Thematic VIP
DWS Government & Agency Securities VIP
DWS High Income VIP
DWS International Select Equity VIP
DWS Janus Growth and Income VIP
DWS Large Cap Value VIP
DWS Mid Cap Growth VIP
DWS Money Market VIP
DWS Small Cap Growth VIP*
DWS Strategic Income VIP
DWS Technology VIP
DWS Xxxxxx Mid Cap Growth VIP
JANUS ASPEN SERIES (SERVICE SHARES)
Janus Aspen Growth and Income Portfolio*
Janus Aspen Large Cap Growth Portfolio*
* As of December 30, 2006, fund has zero-balance, but open to new money.
4
SEPARATE ACCOUNT VA-P
PIONEER VARIABLE CONTRACTS TRUST
Pioneer America Income VCT Portfolio
Pioneer Emerging Markets VCT Portfolio
Pioneer Equity Income VCT Portfolio
Pioneer Fund VCT Portfolio
Pioneer Growth Shares VCT Portfolio
Pioneer High Yield VCT Portfolio
Pioneer Ibbotson Moderate Allocation VCT Portfolio
Pioneer International Value VCT Portfolio*
Pioneer Mid Cap Value VCT Portfolio
Pioneer Money Market VCT Portfolio
Pioneer Real Estate Shares VCT Portfolio
Pioneer Small Cap Value VCT Portfolio*
Pioneer Strategic Income VCT Portfolio
AIM VARIABLE INSURANCE FUNDS (SERIES I SHARES)
AIM V.I. Capital Appreciation Fund
ALLIANCEBERNSTEIN VARIABLE PRODUCTS SERIES FUND, INC. (CLASS B)
AllianceBernstein Global Technology Portfolio
AllianceBernstein Large Cap Growth Portfolio
DELAWARE VIP TRUST (SERVICE CLASS)
Delaware VIP Growth Opportunities Series
Delaware VIP Select Growth Series
FRANKLIN XXXXXXXXX VARIABLE INSURANCE PRODUCTS TRUST (CLASS 2)
FT VIP Franklin Small-Mid Cap Growth Securities Fund
FT VIP Xxxxxxxxx Foreign Securities Fund
FT VIP Templeton Global Asset Allocation Fund
XXX XXXXXX LIFE INVESTMENT TRUST (CLASS I SHARES)
Xxx Xxxxxx LIT Strategic Growth Portfolio
* As of December 30, 2006, fund has zero-balance, but open to new money.
5
SEPARATE ACCOUNT VA-K
DELAWARE MEDALLION ANNUITY CONTRACTS
DELAWARE VIP TRUST
Delaware VIP Balanced Series
Delaware VIP Capital Reserves Series
Delaware VIP Cash Reserve Series
Delaware VIP Emerging Markets Series
Delaware VIP Growth Opportunities Series
Delaware VIP High Yield Series
Delaware VIP International Value
Equity Series
Delaware VIP REIT Series
Delaware VIP Select Growth Series
Delaware VIP Small Cap Value Series
Delaware VIP Trend Series
Delaware VIP U.S. Growth Series
Delaware VIP Value Series
AIM VARIABLE INSURANCE FUNDS
(SERIES I SHARES)
AIM V.I. Capital Appreciation Fund
AIM V.I. Core Equity Fund
AIM V.I. High Yield Fund
AIM V.I. International Growth Fund
THE ALGER AMERICAN FUND (CLASS O)
Xxxxx American Leveraged AllCap Portfolio
Xxxxx American MidCap Growth Portfolio
Alger American Small Capitalization Portfolio
ALLIANCEBERNSTEIN VARIABLE PRODUCTS SERIES FUND, INC. (CLASS B)
AllianceBernstein Global Technology Portfolio
AllianceBernstein Growth and Income Portfolio
AllianceBernstein Growth Portfolio
AllianceBernstein Large Cap Growth Portfolio
FRANKLIN XXXXXXXXX VARIABLE INSURANCE PRODUCTS TRUST (CLASS 2)
FT VIP Franklin Small-Mid Cap Growth Securities Fund
FT VIP Mutual Shares Securities Fund
FT VIP Xxxxxxxxx Foreign Securities Fund
FT VIP Xxxxxxxxx Growth Securities Fund
PIONEER VARIABLE CONTRACTS TRUST (CLASS II)
Pioneer Emerging Markets VCT Portfolio
Pioneer Mid Cap Value VCT Portfolio
6
SELECT SEPARATE ACCOUNT
XXXXXXX XXXXX VARIABLE INSURANCE TRUST (SERVICE SHARES)
Xxxxxxx Sachs Capital Growth Fund
Xxxxxxx Xxxxx Core Fixed Income Fund
Xxxxxxx Sachs Equity Index Fund
Xxxxxxx Xxxxx Government Income Fund
Xxxxxxx Sachs Growth Opportunities Fund
Xxxxxxx Xxxxx Mid Cap Value Fund
Xxxxxxx Sachs Money Market Fund
Xxxxxxx Xxxxx Strategic International Equity Fund
Xxxxxxx Sachs Structured U.S. Equity Fund
AIM VARIABLE INSURANCE FUNDS (SERIES I SHARES)
AIM V.I. Capital Appreciation
AIM V.I. Core Equity Fund
AIM V.I. Dynamics Fund
AIM V.I. Global Health Care Fund
AIM V.I. Large Cap Growth Fund
AIM VARIABLE INSURANCE FUNDS (SERIES II SHARES)
AIM V.I. Basic Value Fund
AIM V.I. Capital Appreciation*
AIM V.I. Capital Development Fund
AIM V.I. Core Equity Fund*
AIM V.I. Capital Development Fund
AIM V.I. Large Cap Growth Fund*
ALLIANCEBERNSTEIN VARIABLE PRODUCTS SERIES FUND, INC. (CLASS A)
AllianceBernstein Large Cap Growth Portfolio
ALLIANCEBERNSTEIN VARIABLE PRODUCTS SERIES FUND, INC. (CLASS B)
AllianceBernstein Large Cap Growth Portfolio
AllianceBernstein Global Technology Portfolio*
AllianceBernstein Growth and Income Portfolio
AllianceBernstein Small/Mid Cap Value Portfolio
AllianceBernstein Value Portfolio
DWS XXXXXXX INVESTMENT VIT FUNDS (CLASS A)
DWS Small Cap Index VIP
DWS VARIABLE SERIES II (CLASS A)
DWS Dreman High Return Equity VIP
DWS Technology VIP
XXXXX XXXXX VARIABLE TRUST
Xxxxx Xxxxx VT Floating-Rate Income Fund
Xxxxx Xxxxx VT Worldwide Health Sciences Fund
FIDELITY VARIABLE INSURANCE PRODUCTS FUNDS
Fidelity VIP Contrafund(R) PortfoliO
Fidelity VIP Equity-Income Portfolio
Fidelity VIP Growth Portfolio
Fidelity VIP Growth & Income Portfolio
Fidelity VIP High Income Portfolio
Fidelity VIP Mid Cap Portfolio
FIDELITY VARIABLE INSURANCE PRODUCTS FUNDS (SERVICE CLASS 2)
Fidelity VIP Contrafund(R) PortfoliO
Fidelity VIP Equity-Income Portfolio
Fidelity VIP Growth Portfolio
Fidelity VIP Growth & Income Portfolio
Fidelity VIP High Income Portfolio
Fidelity VIP Mid Cap Portfolio
Fidelity VIP Value Strategies Portfolio
FRANKLIN XXXXXXXXX VARIABLE INSURANCE PRODUCTS TRUST (CLASS 2)
FT VIP Franklin Large Cap Growth Securities Fund
FT VIP Franklin Small Cap Value Securities Fund
FT VIP Franklin Small-Mid Cap Growth Securities Fund
FT VIP Mutual Shares Securities Fund
FT VIP Xxxxxxxxx Foreign Securities Fund
JANUS ASPEN SERIES (SERVICE SHARES)
Janus Aspen Growth and Income Portfolio
Janus Aspen International Growth Portfolio
Janus Aspen Large Cap Growth Portfolio
Janus Aspen Mid Cap Growth Portfolio
MFS(R) VARIABLE INSURANCE TRUST(SM) (SERVICE SHARES)
MFS(R) Mid Cap Growth SerieS
MFS(R) New Discovery Series
MFS(R) Total Return Series
MFS(R) Utilities Series
XXXXXXXXXXX VARIABLE ACCOUNT FUNDS (SERVICE SHARES)
Xxxxxxxxxxx Balanced Fund/VA
Xxxxxxxxxxx Capital Appreciation Fund/VA
Xxxxxxxxxxx Global Securities Fund/VA
Xxxxxxxxxxx High Income Fund/VA
Xxxxxxxxxxx Main Street Fund(R)/VA
PIONEER VARIABLE CONTRACTS TRUST (CLASS II)
Pioneer Fund VCT Portfolio
Pioneer Real Estate Shares VCT Portfolio
X. XXXX PRICE INTERNATIONAL SERIES, INC.
X. Xxxx Price International Stock Portfolio
* As of December 30, 2006, fund has zero-balance, but open to new money.
7
FULCRUM SEPARATE ACCOUNT
XXXXXXX XXXXX VARIABLE INSURANCE TRUST (SERVICE SHARES)
Xxxxxxx Sachs Core Fixed Income Fund
Xxxxxxx Xxxxx Equity Index Fund
Xxxxxxx Sachs Growth Opportunities Fund
Xxxxxxx Xxxxx Money Market Fund
Xxxxxxx Sachs Strategic International Equity Fund
AIM VARIABLE INSURANCE FUNDS (SERIES I SHARES)
AIM V.I. Core Equity Fund
DELAWARE VIP TRUST
Delaware VIP Balanced Series
Delaware VIP Small Cap Value Series
GABELLI CAPITAL SERIES FUNDS INC.
Gabelli Capital Asset Fund
LAZARD RETIREMENT SERIES INC.
Lazard Retirement International Equity Portfolio
MFS(R)VARIABLE INSURANCE TRUST(SM)
MFS(R) Emerging Growth Series
MFS(R) Investors Trust Series
OLD MUTUAL ADVISOR FUNDS II
Old Mutual Large Cap Growth Concentrated Portfolio
XXXXXXXXXXX VARIABLE ACCOUNT FUNDS
Xxxxxxxxxxx Mid Cap Fund/VA
Xxxxxxxxxxx Xxxx Xxxxxx Xxxx(X)/XX
0
SCHEDULE 2
INSURANCE CONTRACTS
This schedule is an integral part of the Agreement to which it relates.
SCHEDULE 2A INSURANCE CONTRACTS - ANNUITY CONTRACTS*
POLICY FORM MARKETING OR PRODUCT NAME
----------- -------------------------
A3019-92 Delaware Medallion I
A3020-92 Allmerica Select Resource I
A3022-93 Delaware Medallion II
A3023-95 Pioneer Vision 1
A3025-96 Allmerica Select Resources II, Delaware Medallion III,
Pioneer Vision 0, Xxxxxxx Xxxxxxx Xxxxx
X0000-00 Xxxxxxx Gateway Custom
A3027-98 Xxxxxx Advisor, Pioneer C-Vision, Select Charter
A3028-99 Delaware Golden Medallion, Pioneer Xtra Vision, Xxxxxxx
Gateway Plus, Select Reward
A3031-99 Allmerica Select Acclaim
A3035-00 Xxxxxx SBD with EDB, Xxxxxxx Gateway Incentive
A3037-02 Allmerica Optim-L
A3038-02 Gateway Plus II
----------
* This list shall be deemed to include applications, specification pages,
state variations, certificates, binders and administrative forms that are
included and part of the Insurance Contracts. Certain forms, riders and
endorsements may have different or no form numbers and may have been filed
for different distribution channels and products. Therefore, the letter
prefix and numeric suffix to the form numbers can vary. This list shall be
deemed to include those variations.
9
ANNUITY RIDERS AND ENDORSEMENTS*
(TO THE EXTENT APPLICABLE TO THE INSURANCE CONTRACTS - ANNUITY CONTRACTS LISTED
IN SCHEDULE 2A)
LIBERALIZATION OF LIVING BENEFIT
SURRENDER CHARGES OR (ACCELERATED DEATH PREMIUM TAX
DEATH BENEFITS WITHDRAWAL RIGHTS BENEFIT) ENDORSEMENT
---------------------------------- -------------------- ------------------ ---------------
3134-79 3260-99 3290-01 3309-02 3167-82 VAB9-94 3230-92
3197-84 3263-99 3291-00 3311-02 3168-82 2001-91 3232-92
3198-84 3264-99 3292-00 3312-02 3169-82 246-92 3240-92
3231-92 3265-99 3293-00 3313-02 3170L-88 249-94 3241-92
3235-92 3266-99 3303-02 3314-02 3173L-88 3242-92
3249-96 3271-99 3304-02 3315-02 3174L-90 Annuitization 3243-92
3260-99 3272-99 3305-02 3316-02 3239-96 A3104-74
3301-00 3273-99 3306-02 3317-02 3244-96 A3259-99 XXX Endorsement
3240-01 3288-00 3307-02 3318-02 A3268-99 3199-92
3241-01 3289-01 3308-02 A3269-99 3261-98
TSA Endorsement - 3166-81 and 3250-96
Miscellaneous
3150-80 Guaranteed Interest on General Account 3252-97 HO/BIP
3181-83 Qualified Annuities - Separate Account Usage 3262-99 15 Day Money Market Endorsement
3183-83 Qualified Annuities - Separate Account Usage END 4002-98 NY Automatic Reallocation Endorsement
3184-83 Non-Qualified Annuities - Separate Account Usage 3267-99 MAF: Rider
3201-84 General Endorsement - SEC Exemption 27(c)(i) 3270-99 APR Rider
3214-85 Loan Privilege 3274-99 Group/Employee Endorsement
3215-85 Loan Privilege 3275-99 Group/Employee Endorsement
3237-93 Elective Payment Endorsement 3276-99 Qualified Contracts Endorsements
3245-96 Waiver of Surrender Charges 3297-00 Group Policy Endorsement
3246-96 Disability Rider/Waiver of Surrender 3298-00 Xxxxxx Value Enhancement Endorsement
3247-96 Disability Rider/Waiver of Surrender 3319-99 Discount Rider
3248-96 Living Benefits Rider 8054-95 Name Change
----------
* This list shall be deemed to include applications, specification pages,
state variations, certificates, binders and administrative forms that are
included and part of the Insurance Contracts. Certain forms, riders and
endorsements may have different or no form numbers and may have been filed
for different distribution channels and products. Therefore, the letter
prefix and numeric suffix to the form numbers can vary. This list shall be
deemed to include those variations.
10
SCHEDULE 2B INSURANCE CONTRACTS - VARIABLE LIFE CONTRACTS*
(CONTINUED)
POLICY FORM MARKETING NAME
------------------ ------------------------------------------------------
1026-94 Select Variable Inheiritage
1027-95 Select Life
1029P-94, 1029C-94 Group VEL
1030-96 Select SPVUL 2nd to-die, Select SPVUL Single Life,
SPL II (Select)
1033-99 CPA, Xxxxxxx XXX, Select Life Plus, VEL 2001 (Select)
1034-99 Survivorship VUL (Select)
LIFE RIDERS AND ENDORSEMENTS
(TO THE EXTENT APPLICABLE TO THE VARIABLE LIFE CONTRACTS LISTED IN
SCHEDULE 2B)*
LIVING BENEFIT GUARANTEED DEATH
(ACCELERATED DEATH BENEFIT) WAIVER OF PREMIUM BENEFITS RIDERS OTHER INSURED RIDER EXCHANGE OPTION RIDERS
--------------------------- ----------------- ---------------- ------------------- ----------------------
END 239-91 1074-86 1091-97 1067-86 1069-87
1089-95 1086-94 1099-97 1081-94 1090-95
6005-96 CL1086-99 10490 1088-95 VEOP-94
CL1089-99 TA1094-97 CL1099-99 CL1088-99 1084-94
TA1101-98 XXXX-00 XX0000-00 XXXX-00
TA1093-97 1085-94 TA1098-97 FUIT 1088-99 CHILDREN'S INSURANCE
RIDERS
VAB9-94 FUIT 1086-99 FUIT 1099-99 1068-84
2001-91 250-95 1068-95
246-92 TA1096-97
249-94 1082-94
REFUND OF SALES 1035
LOAD/EXCHANGE TO TERM GUARANTEED ACCIDENTAL EXCHANGE
TERM LIFE INSURANCE RIDERS* INSURANCE OPTION INSURABILITY RIDER DEATH BENEFITS RIDERS
--------------------------- --------------------- ------------------ -------------- ---------
1103-99 END 268-97 1066-86 1063-83 8056-96
CL1103-99 END 270-97 1087-95 1080-94 TA1102-98
1105P-00 END 283-99P TA1097-97 CL1089-99
1078-92 UGIR-94
1092-96 1083-94
----------
* This list shall be deemed to include applications, specification pages,
state variations, certificates, binders and administrative forms that are
included and part of the Insurance Contracts. Certain forms, riders and
endorsements may have different or no form numbers and may have been filed
for different distribution channels and products. Therefore, the letter
prefix and numeric suffix to the form numbers can vary. This list shall be
deemed to include those variations.
11
MISCELLANEOUS
230-86 Under 18 Non-Smoker Notice
236-88 Limitation of Liability
237-90 Interest Rate
238-90 Interest Rate
241-91 War Exclusion
242-91 Increase and Earn Exchange
243-91 EL & Endorsement
244-91 Guideline Premium Sum Insured
247-93 VEL & Payor Endorsement
251-95 Minimum Sum Insured Table Endorsement
257-95 Group Variable Universal Life
259-96 Cash Value Test
269-97 Cash Value Accumulation Test
295-01 Loan Interest Endorsement (1033-99)
296-01 Loan Interest Endorsement (1034-99)
289-00 Group Private Placement Endorsement
290-00 Group Private Placement Endorsement
291-00 Policy Loan and Death Benefit Endorsement
293-01 Policy Loan and Partial Withdrawal Endorsement
1079-94 Four Year Term Rider
1076-89 Policy Split Option
1104-99 Survivor Term
END 260-96 Preferred Loan Provision
END 264-96 TSA Endorsement
END 263-96 Paid Up Insurance Benefit
252-95 Name Change
----------
* The list in Schedule 2 shall be deemed to include applications,
specification pages, state variations, certificates, binders and
administrative forms that are included and part of the Insurance Contracts.
Certain forms, riders and endorsements may have different or no form
numbers and may have been filed for different distribution channels and
products. Therefore, the letter prefix and numeric suffix to the form
numbers can vary. This list shall be deemed to include those variations.
12
SCHEDULE 3
REMOVED VARIABLE INSURANCE CONTRACTS
From and after the effective date of Amendment No. 1 to the
Distribution
Agreement, SDI shall no longer be the principal underwriter for the Contracts
set forth below in Schedule 3A and Schedule 3B.
SCHEDULE 3A REMOVED INSURANCE CONTRACTS - ANNUITY CONTRACTS*
POLICY FORM MARKETING OR PRODUCT NAME
----------- -------------------------------------------------------
AVA-FP-67 67 series elective pay
AVA-FP-69 69 series elective pay
AVA-SP-67 67 series single pay
AVA-SP-69 69 series single pay
AVA-ST-67 67 series stipulated pay
VFR - 68 67 series group elective (GA)
VFS - 68 67 series group elective (GB), Flexible Fixed(84-92)
A3001-75 75 series elective pay
A3002-75 75 series elective pay
A3003-75 75 series single pay
A3004-75 75 series single pay
A3005-75 75 Elect Payment Fixed
A3006-75 75 Elect Payment Fixed
X0000-00 Xxxxxxxx XXX (single pay)
A3012-79 78/79 series elective pay
A3013-79 78/79 series elective pay
A3014-79 78/79 series single pay
A3015-79 78/79 series single pay
A3018-91 Exec Annuity Plus 91 (3)
A3021-93 Exec Annuity Plus 93
A3025-96 Allmerica Advantage
A3029-99 Allmerica Immediate Advantage
A3030-99 Allmerica Value Generation, Directed Advisory Solutions
A3036-01 Allmerica Premier Choice
----------
* This list shall be deemed to include applications, specification pages,
state variations, certificates, binders and administrative forms that are
included and part of the Insurance Contracts. Certain forms, riders and
endorsements may have different or no form numbers and may have been filed
for different distribution channels and products. Therefore, the letter
prefix and numeric suffix to the form numbers can vary. This list shall be
deemed to include those variations.
13
REMOVED ANNUITY RIDERS AND ENDORSEMENTS*
(TO THE EXTENT APPLICABLE TO THE REMOVED ANNUITY CONTRACTS LISTED IN
SCHEDULE 3A)
LIBERALIZATION OF LIVING BENEFIT
SURRENDER CHARGES OR (ACCELERATED PREMIUM TAX
DEATH BENEFITS WITHDRAWAL RIGHTS DEATH BENEFIT) ENDORSEMENT
---------------------------------- -------------------- -------------- ---------------
3134-79 3260-99 3290-01 3309-02 3167-82 VAB9-94 3230-92
3197-84 3263-99 3291-00 3311-02 3168-82 2001-91 3232-92
3198-84 3264-99 3292-00 3312-02 3169-82 246-92 3240-92
3231-92 3265-99 3293-00 3313-02 3170L-88 249-94 3241-92
3235-92 3266-99 3303-02 3314-02 3173L-88 3242-92
3249-96 3271-99 3304-02 3315-02 3174L-90 Annuitization 3243-92
3260-99 3272-99 3305-02 3316-02 3239-96 A3104-74
3301-00 3273-99 3306-02 3317-02 3244-96 A3259-99 XXX Endorsement
3240-01 3288-00 3307-02 3318-02 A3268-99 3199-92
3241-01 3289-01 3308-02 A3269-99 3261-98
TSA Endorsement - 3166-81 and 3250-96
Miscellaneous
3150-80 Guaranteed Interest on General Account
3181-83 Qualified Annuities - Separate Account Usage
3183-83 Qualified Annuities - Separate Account Usage
3184-83 Non-Qualified Annuities - Separate Account Usage
3201-84 General Endorsement - SEC Exemption 27(c)(i)
3214-85 Loan Privilege
3215-85 Loan Privilege
3237-93 Elective Payment Endorsement
3245-96 Waiver of Surrender Charges
3246-96 Disability Rider/Waiver of Surrender
3247-96 Disability Rider/Waiver of Surrender
3248-96 Living Benefits Rider
3252-97 HO/BIP
3262-99 15 Day Money Market Endorsement
4002-98 NY Automatic Reallocation Endorsement
3267-99 MAF: Rider
3270-99 APR Rider
3274-99 Group/Employee Endorsement
3275-99 Group/Employee Endorsement
3276-99 Qualified Contracts Endorsements
3297-00 Group Policy Endorsement
3298-00 Xxxxxx Value Enhancement Endorsement
3319-99 Discount Rider
8054-95 Name Change
----------
* This list shall be deemed to include applications, specification pages,
state variations, certificates, binders and administrative forms that are
included and part of the Insurance Contracts. Certain forms, riders and
endorsements may have different or no form numbers and may have been filed
for different distribution channels and products. Therefore, the letter
prefix and numeric suffix to the form numbers can vary. This list shall be
deemed to include those variations.
14
SCHEDULE 3B REMOVED INSURANCE CONTRACTS - LIFE POLICIES *
POLICY FORM MARKETING NAME
----------- --------------------------------------------------
1018-87 VEL 87
1018-91 XXX 00
0000-00 XXX 00
0000-00 XXX PG/VEL Plus
1026-94 Variable Inheiritage (Agency)
1029P-94 Group VEL
1029C-94 Group VEL
1030-96 Agency SPVUL 2nd-to-die, Agency SPVUL Single Life,
Agency SPL II
1033-99 IMO, VEL 2001 (Agency)
1034-99 Survivorship VUL (Agency)
----------
* This list shall be deemed to include applications, specification pages,
state variations, certificates, binders and administrative forms that are
included and part of the Insurance Contracts. Certain forms, riders and
endorsements may have different or no form numbers and may have been filed
for different distribution channels and products. Therefore, the letter
prefix and numeric suffix to the form numbers can vary. This list shall be
deemed to include those variations.
REMOVED LIFE RIDERS AND ENDORSEMENTS
(TO THE EXTENT APPLICABLE TO THE REMOVED LIFE POLICIES LISTED IN SCHEDULE 3B)*
LIVING BENEFIT GUARANTEED DEATH
(ACCELERATED DEATH BENEFIT) WAIVER OF PREMIUM BENEFITS RIDERS OTHER INSURED RIDER EXCHANGE OPTION RIDERS
--------------------------- ----------------- ---------------- ------------------- ---------------------------
END 239-91 1074-86 1091-97 1067-86 1069-87
1089-95 1086-94 1099-97 1081-94 1090-95
6005-96 CL1086-99 10490 1088-95 VEOP-94
CL1089-99 TA1094-97 CL1099-99 CL1088-99 1084-94
TA1101-98 XXXX-00 XX0000-00 XXXX-00
TA1093-97 1085-94 TA1098-97 FUIT 1088-99 Children's Insurance Riders
VAB9-94 FUIT 1086-99 FUIT 1099-99 1068-84
2001-91 250-95 1068-95
246-92 TA1096-97
249-94 1082-94
TERM LIFE REFUND OF SALES
INSURANCE LOAD/EXCHANGE TO TERM GUARANTEED ACCIDENTAL DEATH 1035 EXCHANGE
RIDERS* INSURANCE OPTION INSURABILITY RIDER BENEFITS RIDERS
--------- --------------------- ------------------ ---------------- -------------
1103-99 END 268-97 1066-86 1063-83 8056-96
CL1103-99 END 270-97 1087-95 1080-94 TA1102-98
1105P-00 END 283-99P TA1097-97 CL1089-99
1078-92 UGIR-94
1092-96 1083-94
15
MISCELLANEOUS
230-86 Under 18 Non-Smoker Notice
236-88 Limitation of Liability
237-90 Interest Rate
238-90 Interest Rate
241-91 War Exclusion
242-91 Increase and Earn Exchange
243-91 EL & Endorsement
244-91 Guideline Premium Sum Insured
247-93 VEL & Payor Endorsement
251-95 Minimum Sum Insured Table Endorsement
257-95 Group Variable Universal Life
259-96 Cash Value Test
269-97 Cash Value Accumulation Test
295-01 Loan Interest Endorsement (1033-99)
296-01 Loan Interest Endorsement (1034-99)
289-00 Group Private Placement Endorsement
290-00 Group Private Placement Endorsement
291-00 Policy Loan and Death Benefit Endorsement
293-01 Policy Loan and Partial Withdrawal Endorsement
1079-94 Four Year Term Rider
1076-89 Policy Split Option
1104-99 Survivor Term
END 260-96 Preferred Loan Provision
END 264-96 TSA Endorsement
END 263-96 Paid Up Insurance Benefit
252-95 Name Change
16
