**Berkley National Insurance Company**

A Berkley Company A Stock Company

* **Domicile Address:** 11201 Douglas Avenue, Urbandale, IA 50322-3707
* **Home Office:** 215 Shuman Boulevard, Suite 200, Naperville, IL 60563-8495
* **Underwriting Office:** Berkley Custom Insurance Managers, LLC 633 West 5th Street, Suite 2600 Los Angeles, CA 90071
* **Telephone Number:** (855) 597-7616

**IN WITNESS WHEREOF,** Berkley National Insurance Company has executed and attested these presents.

**Secretary**  
**President**

IL DS 77 00 BNLS 04 10  
© 2010 Berkley National Insurance Company  
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