# INDIVIDUAL SECURITY DETAILS

**POLICY NUMBER:** IBM-0195/BSF03

**AON REFERENCE:** AB2018-00083

**CONDITIONS:** The following conditions apply to this participation only:

**COMPANY:** Chubb Bermuda Insurance Ltd.

**Claims to:**

Claims Department  
Chubb Bermuda Insurance Ltd.  
17 Woodbourne Avenue  
Hamilton HM 08 Bermuda  
Facsimile: 441-292-2456  
E-mail: bermudaclaimsnoces@chubb.com  

**All other Notices to:**

Underwriting Department  
Chubb Bermuda Insurance Ltd.  
17 Woodbourne Avenue  
Hamilton HM 08 Bermuda  
Facsimile: 441-296-7796  

**ENDORSEMENTS:**

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

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

**SIGNED LINES:** USD 50,000,000 excess of USD 550,000,000  

**WRITTEN LINES:** USD 50,000,000 excess of USD 550,000,000  
Chubb Premium: USD 96,030  

**CHUBB® Chubb Bermuda Insurance Ltd.**

* **Limit:** USD 50,000,000  
* **Part of:** USD 50,000,000  
* **Excess of:** USD 550,000,000  
* **Policy #:** IBM-0195/BSF03  
* **Signature:**  
* **Date:** MAY/18/2018