**Policy No.:** BM00027784LI14A

**Date:** June 23, 2014

**b) Minimum Earned Premium:** 0%

**c) Commission:** 0%

**Item 9. The Company:**

XL Insurance (Bermuda) Ltd
O'Hara House
One Bermudiana Road
P.O. Box HM 2245
Hamilton HM JX
Bermuda
Facsimile: (441) 292 1566

**Item 10. Policy Form:**

The Bermuda Shorts Form – 03 (Ed. 03/14)

**Endorsements at Policy Issuance:**

| End No | Title |
|--------|-------|
| 1      | Schedule of Underlying and Quota Share Policies Endorsement |
| 2      | Following Form Bermuda Shorts Form Policy Amendatory Endorsement |
| 3      | Several Liability Notice Endorsement |
| 4      | Premium Payment Condition Endorsement |
| 5      | Following Form Policy Issuance Endorsement |

**IN WITNESS WHEREOF,** this Policy has been made, entered into and executed by the undersigned in Hamilton, Bermuda on this 24th day of June, 2013.

By:
**Authorised Representative**

Title: Assistant Vice President

**XL XS-BSF-03 (Ed. 03/14)**

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