**Policy Number:** WE1300226

**FISCAL AND REGULATORY**

- **TAX PAYABLE BY INSURER(S):** None.
- **COUNTRY OF ORIGIN:** United States of America.
- **OVERSEAS CONSULTANT:** Aon Risk Services Inc. of New York, 199 Water Street, 33rd Floor, New York, NY 10038, United States of America.
- **US CLASSIFICATION:** Self Procured by the Insured.
- **NAIC CODES:** Not applicable.
- **ALLOCATION OF PREMIUM TO CODING:** Not applicable.
- **ALLOCATION OF PREMIUM TO YEARS OF ACCOUNT:** Not applicable.
- **REGULATORY CLIENT CLASSIFICATION:** Large Risk

**Market Submission - Fiscal and Regulatory**
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