**Policy Number:** WE1100159

**FISCAL AND REGULATORY SECTION**

- **TAX PAYABLE BY:** None.
- **UNDERWRITERS:** None.
- **COUNTRY OF ORIGIN:** United States of America.
- **OVERSEAS CONSULTANT:** Aon Risk Services Inc., of New York, 199 Water Street, 32nd Floor, New York, NY 10038, United States of America.
- **US CLASSIFICATION:** Self Procured by the Insured
- **NAIC CODES:** Not applicable.
- **ALLOCATION OF PREMIUM TO CODING:** Not applicable
- **FSA CLIENT CLASSIFICATION:** Large Risk
  - **Aon Risk Classification Code:** LEEA – Large Commercial European Economic Area
- **IS BUSINESS SUBJECT TO DISTANCE MARKETING DIRECTIVE RULES?** Not applicable.

**Market Submission - Fiscal and Regulatory**
Page 22 of 22
RD 10/05/11 03