| Issuing Company's Name: | Berkshire Hathaway Specialty Insurance Company (Admitted) |
|------------------------|---------------------------------------------------------|
| Policy Form Number:    | FF-XS-USF-POL-05/2018 U.S. Short Excess Policy           |
| Policy Number:         | 47-XSF-100238-11                                        |
| Policy Period:         | 05/21/2024 – 05/21/2025                                |
| Premium:               | $410,000 (including TRIA) /0% commission                 |
| Limits:                | $15,000,000 Each Occurrence                             |
|                        | $15,000,000 General Aggregate (Where Applicable)        |
| Attachment:            | $15,000,000 Each Occurrence                             |
|                        | $15,000,000 General Aggregate                          |
|                        | $15,000,000 Products/Completed Operations Aggregate      |

| Issuing Company's Name: | Allianz Global Risks US Insurance Company (Admitted) |
|------------------------|----------------------------------------------------|
| Policy Form Number:    | AGRL XS ASF 2000 10/20 Following Form Excess Liability Short Form |
| Policy Number:         | USL00197724                                         |
| Policy Period:         | 05/21/2024 – 05/21/2025                            |
| Premium:               | $295,800 (including TRIA) /0% commission             |
| Limits:                | $15,000,000 Each Occurrence                         |
|                        | $15,000,000 General Aggregate (Where Applicable)     |
| Attachment:            | $30,000,000 Each Occurrence                         |
|                        | $30,000,000 General Aggregate (Where Applicable)     |

| Issuing Company's Name: | Great American Spirit Insurance Company (Admitted) |
|------------------------|--------------------------------------------------|
| Policy Form Number:    | U.S. Short Excess Form – Coverage Form USX8004 02/18 |
| Policy Number:         | EXC 5613426                                       |
| Policy Period:         | 05/21/2024 – 05/21/2025                           |
| Premium:               | $230,000 (including TRIA) /0% commission           |
| Limits:                | $15,000,000 Each Occurrence                       |
|                        | $15,000,000 General Aggregate (Where Applicable)   |
| Attachment:            | $45,000,000 Each Occurrence                       |
|                        | $45,000,000 General Aggregate (Where Applicable)   |

**NOTICE:** THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK STATE INSURANCE DEPARTMENT. HOWEVER, SUCH FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS.