# DECLARATIONS, cont’d

Which in turn is excess of various insurances and/or retentions as more fully set forth in the Followed Policy All Notices of Occurrence, Claim or Loss:

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

a) To:
Claim Department:
Arch Insurance (Bermuda)
Victoria Hall, 4th Floor
11 Victoria Street
Hamilton HM 11
Bermuda
Email: claims-casualty@archinsurance.bm

b) All other Notices:
To:
Underwriting Department:
Arch Insurance (Bermuda)
Victoria Hall, 4th Floor
11 Victoria Street
Hamilton HM 11
Bermuda

**Item 8.**
a) Premium: US$78,795 (for 100% Flat Annual)
b) Minimum Earned Premium: US$27,578
c) Commission: NET

**Item 9. The Company:** Arch Reinsurance Ltd.
At the address stated at the top of the Declarations Page

**Item 10.**
a) Insured’s Representative: Aon (Bermuda) Ltd
b) Address: Aon House, 30 Woodbourne Avenue Pembroke, HM 08 Bermuda

**Item 11. Policy Form: Endorsements**
The Bermuda Shorts Form – 02 (Ed. 07/09)
1 - 7 at Policy Issuance

**Authorized Representative**
Date: July 18, 2012
Title: Senior Vice President Underwriting Manager, Excess Casualty

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BSF-02 (Ed. 7/09)