# INDIVIDUAL SECURITY DETAILS

**POLICY NUMBER:** C020117/005

**AON REFERENCE:** AB2018-00078

**CONDITIONS:**

The following conditions apply to this participation only:
1) Complete Copies of signed binders (including terms and conditions) for the Followed Policy and for all underlying excess policies (and all quota share carriers) attaching between the Followed Policy and the AW policy.
2) Specimen Copies of any underlying endorsements or policy forms as requested by AW.
3) The premium payable to the Insurer does not include any amount with respect to any applicable taxes. With respect to United Kingdom Insurance Premium Tax (UKIPT), this is due and payable by the Insured. Please provide applicable information to determine if any such tax is due.

**COMPANY:**

Allied World Assurance Company, Ltd.
27 Richmond Road
Pembroke HM08 Bermuda
Telephone: (441)278-5400
Fax No.: (441)296-3428

Claims to:
Claims Department
Allied World Assurance Company, Ltd.
27 Richmond Road
Pembroke HM08 Bermuda
Telephone: (441)278-5400
Fax No.: (441)296-3428
GcnCasClaims@awac.com

**ENDORSEMENTS:**

Endorsement One Schedule of Underlying Policy(ies)
Endorsement Two Premium Payment Condition
Endorsement Three Following Form Policy Issuance
(as noted on the declarations page) and:

Endorsement Four Cancellation Amendatory Endorsement
Endorsement Five Non Follow Form Amendatory Endorsement

**SIGNED LINES:** | **WRITTEN LINES:**

USD 25,000,000 part of USD 200,000,000 excess of USD 200,000,000 | USD 25,000,000 part of USD 200,000,000 excess of USD 200,000,000
Layer Premium: USD 517,930 (100% of layer) | Layer Premium: USD 517,930 (100% of layer)
AWAC Premium: USD 64,741 | AWAC Premium: USD 64,741

**SO**
**ALLIED WORLD ASSURANCE COMPANY, LTD.**
**5/18/18**