**Item 7. Notice to: (Conditions 3 and 4)**

a) All Notices of Occurrence, Claim or Loss:
To:
The Company as shown in the attached Individual Security Details;
And:
Aon Bermuda Ltd.
30 Woodbourne Ave.
Pembroke, Bermuda
HM08
Email: debbie.brown@aon.com and media.williams@aon.com

b) All other Notices:
Via:
Aon Bermuda Ltd.
30 Woodbourne Ave.
Pembroke, Bermuda
HM08
To:
The Company

**Item 8.**
a) Premium: USD 98,430
b) Minimum Earned Premium: 35%
c) Commission: Net

**Item 9.**
The Company:
Name: As per Individual Security Details
Address: As per Individual Security Details

**Item 10.**
Policy Form: The Bermuda Shorts Form – 03 (Ed. 03/14)
Endorsements:
Number One – Schedule of Underlying Policy(ies)
Number Two – Premium Payment Condition
Number Three – Following Form Policy Issuance

Any Additional Endorsements to those shown above will be shown on Individual Security Details (if applicable)

**Page | 2 Declarations**