**Berkley National Insurance Company**

A Stock Company

Domicile Address: 11201 Douglas Avenue, Urbandale, IA 50322-3707

Home Office: 215 Shuman Boulevard, Suite 200, Naperville, IL 60563-8495

Underwriting Office: Berkley Custom Insurance Managers (a W.R. Berkley Company) 725 S Figueroa Street, Suite 2200 Los Angeles, CA 90017

Telephone Number: (855) 597-7616

IN WITNESS WHEREOF, Berkley National Insurance Company has executed and attested these presents.

**Secretary**
**President**

IL DS 77 00 BNLS 04 10
© 2010 Berkley National Insurance Company
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