# DECLARATIONS, continued

**Item 6. Notice to:**
(Conditions 3 and 4)

a. All Notices of Occurrence:
- To:
  - Manager, Claims Department
  - Markel American Insurance Company
  - P. O. Box 2009
  - Glen Allen, VA 23058
  - Fax: 1 (855) 622-7535
  - Email: newclaims@markelcorp.com

b. All other Notices:
- To:
  - Underwriting Department
  - Evanston Insurance Company
  - 1185 Avenue of the Americas, 16th Floor
  - New York, NY 10036
  - Fax: 1 (212) 898-6601

**Item 7.**
a. Premium without TRIA: USD 154,550.00
b. TRIA Premium: USD
c. Total Premium: USD 154,550.00 (for 100% Flat Annual)
d. Minimum Earned Premium: USD 38,638.00

**Item 8. The Company:** MARKEL AMERICAN INSURANCE COMPANY

**Item 9. Producer:** Aon Risk Services Northeast, Inc.

**Item 10. Policy Form:**
- MGDEC 4011 01 19
- MJ IL 1000 06 10
- MPIL 1007 01 20
- MPIL 1044-NY 08 12
- MPIL 1083 04 15
- MDIL 1001 08 11
- MIL 1214 09 17
- MGDEC 4011 01 19
- MGEC 4008 01 19
- MGEC 4244 04 18
- MGEC 4247 04 18
- MUB TERR-1 01 15

**Endorsements:**
- Policy Jacket
- Privacy Notice
- New York Free Trade Zone Notice (Classes 1 and 2)
- "U.S. Treasury Department's Office Of Foreign Assets Control ("OFAC")" Advisory Notice To Policyholders"
- Forms Schedule
- Trade or Economic Sanctions
- U.S. Short Excess Form Declarations
- U.S. Short Excess Form
- Endorsement No.1 Schedule Of Excess Policies)
- Minimum Earned Premium
- Confirmation Of Certified Acts Of Terrorism Coverage - Terrorism Risk Insurance Act

These Declarations, together with the Coverage Form and any Endorsement(s), complete the above numbered policy.