# Berkley National Insurance Company

A Berkley Company A Stock Company

**Domicile Address:** 11201 Douglas Avenue, Urbandale, IA 50322-3707  
**Home Office:** 215 Shuman Boulevard, Suite 200, Naperville, IL 60563-8495  
**Underwriting Office:** Berkley Custom Insurance Managers, LLC 725 South Figueroa Street, Suite 2200 Los Angeles, CA 90017  
**Telephone Number:** (855) 597-7616

**IN WITNESS WHEREOF,** Berkley National Insurance Company has executed and attested these presents.

**Secretary**

**President**

IL DS 77 00 BNLS 04 10 © 2010 Berkley National Insurance Company Page 1 of 1