**Policy No.: BM00023605L108A**

**FOLLOWING FORM EXCESS LIABILITY INSURANCE POLICY**
**OCCURRENCE FORM**
**DECLARATIONS (CONTINUED)**

**All other Notices to the Company:**
- **Attn:** XL Insurance (Bermuda) Ltd
  - XL House
  - One Bermudiana Road
  - P.O. Box HM 2245
  - Hamilton HM JX
  - Bermuda
  - Facsimile: (441) 292 1566

**(10) POLICY FORM:** XL XS-OCC (11/03)

**(11) SCHEDULE OF ENDORSEMENTS:**
- End. No. 1 – Follow Form Occurrence Policy Amendatory Endorsement (XSOCC-025.01)
- End. No. 2 – Several Liability for Quota Share Coverage Endorsement (XSOCC-301.02)
- End. No. 3 – Amendment of Article II Endorsement (XSOCC-300.02)

**IN WITNESS WHEREOF, this Policy has been made, entered into and executed by the undersigned in Hamilton, Bermuda this 8TH day of SEPTEMBER, 2008.**

**BY:**
**VICTORIA BENEVIDES**
**TITLE:** ASSISTANT VICE PRESIDENT

**FORM XL XS-OCC (11/03)**