Form of ADDENDUM TO SCHEDULE OF PARTICIPATON AGREEMENT
Form of ADDENDUM TO SCHEDULE OF
This Addendum (“Addendum”) to the original Schedule of the Participation Agreement executed on December 19, 2003 is entered into by and among Royce Fund Services, Inc., (the “Distributor”), Royce Capital Fund (the “Fund”), and Protective Life and Annuity Insurance Company (the “Company”), collectively (the “Parties”).
WHEREAS, the Parties entered into a Participation Agreement dated November 1, 2009 (the “Agreement”). Capitalized terms used herein and not otherwise defined herein shall have the meanings assigned to such terms in the Agreement;
NOW, THEREFORE, in consideration of these premises and the terms and conditions set forth herein, the Parties agree as follows:
1. The following Separate Accounts and Contracts are added to Schedule B of the Agreement:
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Separate Accounts
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Contracts
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Schwab Genesis Advisory Variable Annuity NY
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Schwab Genesis Variable Annuity NY
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For the purpose of referring to this Amendment, the date of this Amendment shall be [DATE].
Royce Fund Services, Inc.
Protective Life and Annuity Insurance Company
Name:
___________________________
Name:
___________________________
Title:
___________________________
Title:
___________________________
Date: ___________________________
Date: ____________________________
Royce Capital Fund
By:
___________________________
Name:
___________________________
Title:
___________________________
Date: ___________________________
