FUND PARTICIPATION AGREEMENT AMENDMENT
This Fund Participation Agreement Amendment hereby amends the Fund Participation
Agreement dated June 1999, as amended, between the Allmerica Financial Life and
Annuity Insurance Company, and each of Dreyfus Investment Portfolios, The
Dreyfus Socially Responsible Growth Fund, Inc. and the Dreyfus Variable
Investment Fund ("Agreement") in the following manner:
The Agreement is amended to replace Exhibit B in its entirety by the revised
Exhibit B, attached hereto.
IN WITNESS WHEREOF, the parties hereto have executed this Fund Participation
Agreement Amendment as of December 15, 2001.
ALLMERICA FINANCIAL LIFE AND
ANNUITY INSURANCE COMPANY
By:_________________________________
Name:
Title:
Attest:_____________________________
THE DREYFUS SOCIALLY RESPONSIBLE
GROWTH FUND, INC.
By:_________________________________
Name:
Title:
Attest:_____________________________
DREYFUS VARIABLE INVESTMENT FUND
By:_________________________________
Name:
Title:
Attest:_____________________________
DREYFUS INVESTMENT PORTFOLIOS
By:_________________________________
Name:
Title:
Attest:_____________________________
EXHIBIT B
CONTRACTS OF THE COMPANY
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CONTRACT 1 CONTRACT 2 CONTRACT 3
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CONTRACT/PRODUCT NAME Xxxxxxx Gateway Elite Xxxxxxx Gateway Custom Xxxxxxx Gateway Advisor
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REGISTERED (Y/N) Y Y Y
SEC REGISTRATION NUMBER 333-9965 333-10283 333-63091
REPRESENTATIVE FORM A3025-96 A3026-96 A3027-98
NUMBERS
SEPARATE ACCOUNT Separate Account KG of Separate Account KGC of Separate Account KG of
NAME/DATE ESTABLISHED Allmerica Financial Life Allmerica Financial Life Allmerica Financial Life
Insurance and Annuity Company Insurance and Annuity Company Insurance and Annuity Company
SEC REGISTRATION NUMBER 811-7767 811-7777 811-7767
PORTFOLIOS Dreyfus Investment Dreyfus Investment Portfolios: Dreyfus Investment
Portfolios: - MidCap Stock Portfolios:
- MidCap Stock Portfolio - MidCap Stock
Portfolio Portfolio
The Dreyfus Socially The Dreyfus Socially The Dreyfus Socially
Responsible Growth Fund, Inc. Responsible Growth Fund, Inc. Responsible Growth Fund, Inc.
EXHIBIT B (continued)
CONTRACTS OF THE COMPANY
---------------------------------------------------------------------------------------------------------------------------
CONTRACT 4 CONTRACT 5 CONTRACT 6
---------------------------------------------------------------------------------------------------------------------------
CONTRACT/PRODUCT NAME Xxxxxxx Gateway Plus Xxxxxxx Gateway Advisor 2 ValuePlus Assurance
---------------------------------------------------------------------------------------------------------------------------
REGISTERED (Y/N) Y Y Y
SEC REGISTRATION NUMBER 333-81019 333-90539 333-93031
REPRESENTATIVE FORM A3028-99 A3030-99 1036-99
NUMBERS
SEPARATE ACCOUNT Separate Account KG of Separate Account KG of FUVUL Separate Account of
NAME/DATE ESTABLISHED Allmerica Financial Life Allmerica Financial Life Allmerica Financial Life
Insurance and Annuity Company Insurance and Annuity Company Insurance and Annuity Company
SEC REGISTRATION NUMBER 811-7767 811-7767 811-09731
PORTFOLIOS Dreyfus Investment Dreyfus Investment Portfolios: Dreyfus Variable Investment
Portfolios: Fund:
- MidCap Stock - MidCap Stock Portfolio - Appreciation
Portfolio Portfolio
- Quality Bond
Portfolio
The Dreyfus Socially The Dreyfus Socially The Dreyfus Socially
Responsible Growth Fund, Inc. Responsible Growth Fund, Inc. Responsible Growth Fund, Inc.
---------------------------------------------------------------------------------------------------------------------------
EXHIBIT B (continued)
CONTRACTS OF THE COMPANY
---------------------------------------------------------------------------------------------------------------------------
CONTRACT 7 CONTRACT 8 CONTRACT 9
---------------------------------------------------------------------------------------------------------------------------
CONTRACT/PRODUCT NAME PremierFocus PremierFocus First Union IVA
---------------------------------------------------------------------------------------------------------------------------
REGISTERED (Y/N) N N Y
SEC REGISTRATION NUMBER N/A N/A Pending
REPRESENTATIVE FORM 1037-99 1037-99 A3029-99
NUMBERS
SEPARATE ACCOUNT FR1 of Allmerica Financial FQ1 of Allmerica Financial Separate Account VA-K of
NAME/DATE ESTABLISHED Life Insurance and Annuity Life Insurance and Annuity Allmerica Financial Life
Company Company Insurance and Annuity Company
SEC REGISTRATION NUMBER N/A N/A 811-6293
PORTFOLIOS Dreyfus Variable Investment Dreyfus Variable Investment
Fund: Fund:
- Appreciation Portfolio - Appreciation
- Quality Bond Portfolio Portfolio
- Money Market Portfolio - Quality Bond
Portfolio
The Dreyfus Socially The Dreyfus Socially The Dreyfus Socially
Responsible Growth Fund, Inc. Responsible Growth Fund, Inc. Responsible Growth Fund, Inc.
---------------------------------------------------------------------------------------------------------------------------
EXHIBIT B (continued)
CONTRACTS OF THE COMPANY
---------------------------------------------------------------------------------------------------------------------------
CONTRACT 10 CONTRACT 11 CONTRACT 12
---------------------------------------------------------------------------------------------------------------------------
CONTRACT/PRODUCT NAME First Union Private Placement First Union Private Placement Xxxxxxx Gateway Incentive
Annuity Annuity (Secondary)
---------------------------------------------------------------------------------------------------------------------------
REGISTERED (Y/N) N N Y
SEC REGISTRATION NUMBER N/A N/A 333-46716
REPRESENTATIVE FORM A3034-00 A3034-00 A3032-00
NUMBERS
SEPARATE ACCOUNT UR1 of Allmerica Financial UQ1 of Allmerica Financial Separate Account KG
NAME/DATE ESTABLISHED Life Insurance and Annuity Life Insurance and Annuity
Company Company
SEC REGISTRATION NUMBER N/A N/A 811-7767
PORTFOLIOS Dreyfus Variable Investment Dreyfus Investment
Fund: Portfolios:
- Appreciation Portfolio - MidCap Stock
- Quality Bond Portfolio Portfolio
The Dreyfus Socially The Dreyfus Socially The Dreyfus Socially
Responsible Growth Fund, Inc. Responsible Growth Fund, Inc. Responsible Growth Fund, Inc.
---------------------------------------------------------------------------------------------------------------------------
EXHIBIT B (continued)
CONTRACTS OF THE COMPANY
---------------------------------------------------------------------------------------------------------------------------
CONTRACT 11 CONTRACT 12 CONTRACT 13
---------------------------------------------------------------------------------------------------------------------------
CONTRACT/PRODUCT NAME Xxxxxxx Gateway Flex Life
---------------------------------------------------------------------------------------------------------------------------
REGISTERED (Y/N) Y
SEC REGISTRATION NUMBER 333-84879
REPRESENTATIVE FORM TBD
NUMBERS
SEPARATE ACCOUNT Separate Account IMO
NAME/DATE ESTABLISHED
SEC REGISTRATION NUMBER 811-09529
PORTFOLIOS Dreyfus Investment
Portfolios:
- MidCap Stock
Portfolio
The Dreyfus Socially
Responsible Growth Fund, Inc.
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