# INDIVIDUAL SECURITY DETAILS

**POLICY NUMBER:** IBM-0572/BSF03

**AON REFERENCE:** AB2022-00113

**CONDITIONS:**

The following conditions apply to this participation only:
1) Complete Copies of signed binders (including terms and conditions) for the Followed Policy and for all underlying excess policies (and all quota share policies) attaching between the Followed Policy and the Chubb Bermuda policy.
2) The premium payable to the Insurer does not include any amount with respect to any applicable taxes. With respect to United Kingdom Insurance Premium Tax (UKIPT), any tax due is payable by the Insured. Please provide applicable information to determine if any such tax is due.
3) Quote Expiry Date: N/A

**COMPANY:** Chubb Bermuda Insurance Ltd.

**Claims to:**

Claims Department  
Chubb Bermuda Insurance Ltd.  
17 Woodbourne Avenue  
Hamilton HM 08, Bermuda  
Facsimile: +1 (441)292-2456  
E-mail: bermudclaimsnotices@chubb.com  

**All other Notices to:**

Underwriting Department  
Chubb Bermuda Insurance Ltd.  
17 Woodbourne Avenue  
Hamilton HM 08, Bermuda  
Facsimile: +1 (441)296-7796  

**ENDORSEMENTS:**

One Schedule of Underlying Policy(ies)
Two Following Form Policy Issuance
(as shown on the declarations page), and:
Three Cancellation Amendatory Endorsement
Four Trade or Economic Sanctions Endorsement

**SIGNED LINES:** USD 25,000,000 part of USD 50,000,000 excess of USD 300,000,000 (100%)

**WRITTEN LINES:**

USD 25,000,000 part of USD 50,000,000 excess of USD 300,000,000
Layer Premium: USD 281,622
Chubb Premium: USD 140,811

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