| C. Type of Insurance | Excess Follow-Form |
|---|---|
| D. Policy Period | Effective From: 05/21/2018 to 05/21/2019; |

**PREMIUM:**

| Total Advance | $72,530 |
|---|---|
| Total Minimum Annual | $72,530 |
| Minimum Earned | 35% |
| Terrorism Premium Included in Advanced | $725 |
| Estimated Total Annual Exposure | $80,092,374,240 of Total Sales |
| Auditable/Not Auditable | Not Auditable |
| Rate | Flat |

**COMMISSION:**

| 0% |

**RETROACTIVE DATE:**

| Not Applicable |

**ENDORSEMENTS:**

| FF-XS-019-12/2015 | Follow Form Excess Liability Policy (Short Form) |
| FF-XS-020-12/2014 | Schedule of Excess Policy(ies) |
| FFP-XS-004-07/2014 | Non Follow Form Endorsement |
| FFP-XS-010-02/2014 | Quota-Share Participation Condition Endorsement |
| NYP-UN-001-11/2013 | NYFTZ -Cancellation, Nonrenewal, and Conditional Renewal (New York Free Trade Zone) |
| CL-UN-075-12/2016 | Cap On Losses From Certified Acts of Terrorism (ISO Based) |

**NOTICES:**

- Terrorism Disclosure Notice

**Terms and Conditions:**

- Premium is due within 30 days of the Effective Date of the policy.
- This binder is based on information received and is subject to reconsideration if different or additional information is obtained.
- Some coverages/endorsements provided in this binder may differ from that requested in your submission. Please review carefully.
- Our final layer pricing is subject to our review and acceptance of all actual excess layer pricing above our layer. We reserve the right to adjust our premium if we determine any participation placed excess of our layer attracts a disproportionate rate per million.
- The policy will include the exclusions and endorsements per the attached schedule.
- If, between the date of the original submission and the effective date of this binder, there is a material change in any of the information (including but not limited to claims or potential claims) originally submitted or subsequently requested by the Company, the insured is required to notify the Company immediately. The Company reserves the right to terminate this binder or modify the terms of this binder in event of a material change in such information.

**Subject To:**

- None.

**Other:**

- Office of Foreign Assets Control (OFAC) Disclosure Notice: This proposal or resulting Binder, the continuation of any bound insurance, and any payments to you, to a claimant or to another third party, may be affected by the administration and enforcement of U.S. economic embargoes and trade sanctions by the office of Foreign Assets