# Endurance

**POLICY NO.:** EXC10000024500  
**NEW BUSINESS**

## DECLARATIONS, cont’d

### Item 7 Notice to:
(Conditions 3 and 5)
- **a) All Notices of Occurrence, Claim or Loss:**
  - To:
    - Endurance Specialty Insurance Ltd
    - Wellesley House
    - 90 Pitts Bay Road, Pembroke
    - Bermuda HM08
- **b) All other Notices:**
  - To:
    - Aon (Bermuda) Ltd
    - Cumberland House
    - One Victoria Street
    - Hamilton, Bermuda HM11

### Item 8
- **a) Premium:** US$ 125,000 (for 100% Flat Annual)
- **b) Minimum Earned Premium:** US$ 43,750
- **c) Commission:** Net

### Item 9 The Company:
- Endurance Specialty Insurance Ltd
- At the address stated at the top of the Declarations Page

### Item 10 Policy Form:
- Endorsements
- The Bermuda Shorts Form – 01 (Ed 02/09)
- 1 - 6 at Policy Issuance

**Authorized Representative**

**Documents Checked**
- OK
- By:

**Page 2 of 6**

**Date of Issuance:** June 19, 2009
**BSP-01 (Ed 02/09)**