# DECLARATIONS, cont'd

**Item 6. Notice to: (Conditions 3 and 4)**

- **a. All Notices of Occurrence:**
  - **To:** Great American Custom Insurance Services  
    725 South Figueroa Street, Suite 3400  
    Los Angeles, CA 90017  

- **b. All other Notices:**
  - **To:** Great American Professional Risk Ins.  
    3436 Torington Way, Suite 200  
    Charlotte, NC 28277  

**Item 7.**

- **a. Premium without Terrorism (Certified Acts):** USD $216,400.00  
- **b. Terrorism (Certified Acts) Premium:** USD $0.00  
- **c. Surcharges:** USD  
- **d. Taxes:** USD  
- **e. Total Premium:** USD $216,400.00 (for 100% Flat Annual)  
- **f. Minimum Earned Premium:** USD  

**Item 8. The Company:**  
Great American Spirit Ins. Company  
301 E Fourth St.  
Cincinnati, Ohio 45202  

**Item 9. Producer:**  
Aon Risk Services Northeast Inc  
One Liberty Plaza 165 Broadway Ste. 3201  
New York, NY 10006  

USX 8002 (Ed. 02/18)  
(Page 2 of 3)