# Endurance Specialty Insurance Ltd.

**The Wellesley House, 90 Pitts Bay Road, Pembroke HM08, Bermuda**

**Telephone:** 441-278-0400 **Facsimile:** 441-296-1474

**For Claim Matters Only:** Facsimile: 441-296-5151 or excesscasualtyclaims@endurance.bm

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**POLICY NO.:** EXC10000024503  
**RENEWAL OF:** EXC10000024502

## DECLARATIONS, cont’d

### Item 7. Notice to:
**(Conditions 3 and 5)**

a) All Notices of Occurrence, Claim or Loss:

To:
Endurance Specialty Insurance Ltd.
Wellesley House
90 Pitts Bay Road, Pembroke
Bermuda HM08

b) All other Notices:

To:
Aon (Bermuda) Ltd.
Aon House
30 Woodbourne Avenue
Pembroke, Bermuda HM 08

### Item 8.
a) Premium: USD 121,250 (for 100% Flat Annual)
b) Minimum Earned Premium: USD 42,438
c) Commission: Net

### Item 9. The Company:
Endurance Specialty Insurance Ltd.
At the address stated at the top of the Declarations Page

### Item 10. Policy Form: Endorsements
The Bermuda Shorts Form – 02 (Ed. 07/09)

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**Theresa Binks-Lotem**
**Authorized Representative**

**Page 2 of 7**

**Date of Issuance:** June 5, 2012  
**BSF-02 Declarations (Ed. 07/09)**