# Policy Period Premium

| **$ 1,042,248** | **Premium** | **$50,000** | **Terrorism Premium included in Annual Premium** |
|-----------------|-------------|-------------|--------------------------------------------------|
| **$ 0**         | **State Surcharge** | **$1,042,248** | **Premium, including all Surcharges and Assessments** |

## Schedule of Underlying Insurance

Refer to the attached Schedule of Underlying Insurance, which forms a part of this Policy's Declarations.

## Endorsements and Forms

Refer to the attached Schedule of Endorsements for the forms and endorsements forming this policy at inception.