0001037155-14-000034 Sample Contracts

CONTRACT AMENDMENT
Flexible Premium Variable Annuity Contract • August 18th, 2014 • Variable Annuity I Ser Acc of GRT West Li & Annu Ins Co of Ny

THIS AMENDMENT IS ISSUED BY GREAT‑WEST LIFE & ANNUITY INSURANCE COMPANY OF NEW YORK AS PART OF THE FLEXIBLE PREMIUM VARIABLE ANNUITY CONTRACT (THE “CONTRACT”) TO WHICH IT IS ATTACHED. Except as expressly aMENDED by this AMENDMENT, the terms and conditions of the contract shall remain in full force and effect. if there is any conflict between this amendment and the contract the terms of this amendment will prevail.

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