# DECLARATIONS, cont’d

Which in turn is excess of various insurances and/or retentions as more fully set forth in the Followed Policy

**Item 7. Notice to: (Conditions 3 and 5)**

a) All Notices of Occurrence, Claim or Loss:

To:
- Claim Department:
  - Arch Insurance (Bermuda)
  - Victoria Hall, 4th Floor
  - 11 Victoria Street
  - Hamilton HM 11
  - Bermuda

b) All other Notices:

To:
- Underwriting Department:
  - Arch Insurance (Bermuda)
  - Victoria Hall, 4th Floor
  - 11 Victoria Street
  - Hamilton HM 11
  - Bermuda

**Item 8.**
a) Premium: US$78,795 (for 100% Flat Annual)
b) Minimum Earned Premium: US$27,578
c) Commission: NET

**Item 9. The Company:** Arch Reinsurance Ltd.
At the address stated at the top of the Declarations Page

**Item 10.**
a) Insured’s Representative: Aon (Bermuda) Ltd
b) Address: Aon House, 30 Woodbourne Avenue
Pembroke, HM 08
Bermuda

**Item 11. Policy Form: Endorsements**
The Bermuda Shorts Form – 02 (Ed. 07/09)
1 - 5 at Policy Issuance

**Authorized Representative**

Date: June 15, 2011
Title: Senior Vice President
Underwriting Manager,
Excess Casualty

Page 2 of 2

BSF-02 (Ed. 709)