EXHIBIT 99.A4-2
Exhibit 27(h)(iv)
Amendment No. 21 to Participation Agreement between AEGON/Transamerica
Series Fund, Inc. and Western Reserve dated September 1, 2003
AMENDMENT NO. 21 TO
PARTICIPATION AGREEMENT AMONG
AEGON/TRANSAMERICA SERIES FUND, INC.,
TRANSAMERICA LIFE INSURANCE COMPANY,
AUSA LIFE INSURANCE COMPANY, INC.,
PEOPLES BENEFIT LIFE INSURANCE COMPANY,
TRANSAMERICA OCCIDENTAL LIFE INSURANCE COMPANY AND
TRANSAMERICA LIFE INSURANCE AND ANNUITY COMPANY
TRANSAMERICA LIFE INSURANCE COMPANY OF NEW YORK
Amendment No. 21 to the Participation Agreement among
AEGON/Transamerica Series Fund, Inc., (the "Fund"), Transamerica Life Insurance
Company ("Transamerica"), AUSA Life Insurance Company, Inc. ("AUSA Life"),
Peoples Benefit Life Insurance Company ("Peoples"), Transamerica Occidental Life
Insurance Company ("TOLIC"), Transamerica Life Insurance and Annuity Company
("TALIAC") and Transamerica Life Insurance Company of New York ("XXXX") dated
July 1, 1992, as amended ("Participation Agreement").
WHEREAS, Peoples has, by resolution of its Board of Directors, duly
organized and established the AES Private Placement VA Separate Account (the
"Account") as a segregated asset account to receive, set aside and invest assets
attributable to net premiums and payments received under the Contract and such
variable annuity contract will be partly funded by the Fund; and
WHEREAS, to the extent permitted by applicable insurance law and
regulation, Peoples intends to purchase shares in one or more of the portfolios
of the Fund to fund their Contracts on behalf of the Account, as specified in
Schedule A attached to this Amendment, as such Schedule A is amended by this
Amendment No. 21, and as Schedule A may be amended from time to time.
NOW, THEREFORE, IT IS HEREBY AGREED that Peoples, through its separate
accounts, AES Private Placement VA Separate Account will purchase and redeem
shares issued by the Fund, subject to the terms and conditions of the
Participation Agreement. It is also agreed that Schedule A to the Participation
Agreement is hereby amended to add the AES Private Placement VA Separate
Account, as an additional "Account;" and to add the Advisor's Edge Select
Private Placement contract issued by Peoples, to the list of "Policies" of the
Fund.
IN WITNESS WHEREOF, each of the parties has caused this Amendment to be
executed in its name and on its behalf by its duly authorized representative as
of June 1, 2002.
TRANSAMERICA LIFE INSURANCE AEGON/TRANSAMERICA SERIES
COMPANY FUND, INC.
By its authorized officer By its authorized officer
By: /s/ Xxxxx X. Xxxxxx By: /s/ Xxxx X. Xxxxxx
---------------------------- --------------------------------
Xxxxx X. Xxxxxx Xxxx X. Xxxxxx
Title: President Title: Vice President, Secretary
and General Counsel
AUSA LIFE INSURANCE PEOPLES BENEFIT LIFE INSURANCE
COMPANY, INC. COMPANY
By its authorized officer By its authorized officer
By: /s/ Xxxxx X. Xxxxxx By: /s/ Xxxxx X. Xxxxxx
---------------------------- --------------------------------
Xxxxx X. Xxxxxx Xxxxx X. Xxxxxx
Title: Vice President Title: Executive Vice President
TRANSAMERICA OCCIDENTAL LIFE TRANSAMERICA LIFE INSURANCE
INSURANCE COMPANY AND ANNUITY COMPANY
By its authorized officer By its authorized officer
By: /s/ Xxxxxxxxx X. Xxxxxxx By: /s/ Xxxxxxxxx X. Xxxxxxx
----------------------------- -------------------------------
Xxxxxxxxx X. Xxxxxxx Xxxxxxxxx X. Xxxxxxx
Title: Assistant Vice President and Title: Assistant Vice President
Assistant Secretary and Assistant Secretary
TRANSAMERICA LIFE INSURANCE COMPANY OF NEW YORK
By its authorized officer
By: /s/ Xxxxxx X. Xxxxxxx
------------------------------
Xxxxxx X. Xxxxxxx
Title: Vice President
AMENDED SCHEDULE A
Effective June 1, 2002
Account(s), Policy(ies) and Portfolio(s)
Subject to the Participation Agreement
Accounts: Separate Account VA B
Separate Account VA BNY
Mutual Fund Account
Separate Account VA A
Separate Account VA C
Separate Account VA D
Retirement Builder Variable Annuity Account
AUSA Life Insurance Company, Inc. Separate Account C
Peoples Benefit Life Insurance Company Separate Account V
Legacy Builder Variable Life Separate Account
AUSA Series Life Account
AUSA Series Annuity Account
Transamerica Occidental Life Separate Account VUL-3
Separate Account VA E Separate Account VA F
Transamerica Occidental Life Separate Account VUL-4
Transamerica Occidental Life Separate Account VUL-5
Transamerica Life Insurance and Annuity Company on behalf
of its Separate Account VA-8
Separate Account VA J
Transamerica Occidental Life Separate Account VUL-6
TA PPVUL 1
Separate Account K
Separate Account H
Separate Account G
Separate Account VA-2LNY
Separate Account VA-2L
Separate Account VL A
AES Private Placement VA Separate Account
Policies: Transamerica Landmark Variable Annuity
AUSA Landmark Variable Annuity
The Atlas Portfolio Builder Variable Annuity
Transamerica EXTRA Variable Annuity
Transamerica Access Variable Annuity
Retirement Income Builder II Variable Annuity
AUSA & Peoples - Advisor's Edge Variable Annuity
Peoples - Advisor's Edge Select Variable Annuity
Legacy Builder Plus
AUSA Financial Freedom Builder
Transamerica Elite
Privilege Select Variable Annuity
Estate Enhancer Variable Life
AMENDED SCHEDULE A (CONTINUED)
Policies (continued):
TransSurvivor Life Variable Universal Life
TransMark Optimum Choice Variable Annuity
TransUltra(R) Variable Universal Life
AUSA Freedom Elite Builder
AUSA Premier Variable Annuity
Immediate Income Builder II
Premier Asset Builder Variable Annuity
TransAccumulator VUL cv
AUSA Freedom Wealth Protector
Advantage V
Retirement Income Builder Variable Annuity
Retirement Income Builder III Variable Annuity
Dreyfus Advisor Advantage Variable Annuity
Dreyfus Access Advantage Variable Annuity
Dreyfus/Transamerica Triple Advantage(R) Variable Annuity (NY)
Dreyfus/Transamerica Triple Advantage(R) Variable Annuity
Transamerica Variable Life
Advisor's Edge Select Private Placement
Portfolios: AEGON/Transamerica Series Fund, Inc.
Janus Growth
AEGON Bond
Transamerica Money Market
Janus Global
LKCM Strategic Total Return
Xxx Xxxxxx Emerging Growth
Xxxxx Aggressive Growth
Federated Growth & Income
PBHG/NWQ Value Select
GE U.S. Equity
Clarion Real Estate Securities
X. Xxxx Price Dividend Growth
X. Xxxx Price Small Cap
Xxxxxxx Xxxxx Growth
PBHG Mid Cap Growth
Salomon All Cap
Dreyfus Mid Cap
Third Avenue Value
Transamerica Value Balanced
Great Companies - America (sm)
Great Companies - Technology (sm)
Value Line Aggressive Growth
AMENDED SCHEDULE A (CONTINUED)
Portfolios: AEGON/Transamerica Series Fund, Inc. (continued)
Gabelli Global Growth
Great Companies - Global(2)
LKCM Capital Growth
American Century International
American Century Income & Growth
Munder Net50
BlackRock Large Cap Value
BlackRock Mid Cap Growth
BlackRock Global Science & Technology
Aggressive Asset Allocation
Capital Guardian Global
Capital Guardian U.S. Equity
Capital Guardian Value
Conservative Asset Allocation
Dreyfus Small Cap Value
X.X. Xxxxxx Enhanced Index
Janus Balanced
Janus Growth II
Xxxxxxxx Growth
MFS High Yield
Moderate Asset Allocation
Moderately Aggressive Asset Allocation
PIMCO Total Return
Protected Principal Stock
X. Xxxx Price Equity Income
X. Xxxx Price Growth Stock
Transamerica Equity
Transamerica Convertible Securities
Transamerica Growth Opportunities
Transamerica U.S. Government Securities
Xxx Xxxxxx Active International Allocation
Xxx Xxxxxx Asset Allocation
Xxx Xxxxxx Money Market
