EXCESS OVERLAYER INDEMNITY POLICY

(Exclusion-Contamination or Pollution)

It is agreed that the policy does not apply to EXCESS NET LOSS arising out of the discharge, dispersal, release or escape of smoke, vapors, soot, fumes, acids, alkalis, toxic chemicals, liquids or gases, waste materials or other irritants, contaminants or pollutants into or upon land, the atmosphere or any watercourse or body of water; but this exclusion does not apply if such discharge, dispersal, release or escape is sudden and accidental.

This endorsement, issued by one of the below named companies, forms a part of the policy to which attached, effective on the inception date of the policy unless otherwise stated herein.

(The Information below is required only when this endorsement is issued subsequent to preparation of policy.)

Endorsement effective: [Date]
Policy No.: [Policy Number]
Endorsement No.: 2

Named Insured: [Name]
Additional Premium $: [Amount]

Return Premium $:
BI: $ [Amount]
PD: $ [Amount]

In Advance $: $ [Amount]
1st Anniv. $: $ [Amount]
2nd Anniv. $: $ [Amount]

The Aetna Casualty and Surety Company
The Standard Fire Insurance Company
Hartford, Connecticut

Countersigned by: [Authorized Representative]