# IRON·STARR

## THE BERMUDA SHORTS FORM (cont'd)

**DECLARATIONS - attaching to and forming part of Policy No:** IS0001324

### Item 6. Underlying Limits:
- **(Insuring Agreement 2):**
  - a) USD 450,000,000 Each Occurrence, Claim or Loss
  - b) USD 450,000,000 Annual Aggregate
  - 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: Iron-Starr Excess Agency Ltd.
      Attention: Claims Manager
      141 Front Street
      Hamilton HM19, Bermuda
      claims@ironstarrecess.com
  - b) All other Notices:
    - To: Iron-Starr Excess Agency Ltd.
      Attention: Underwriting Dept.
      141 Front Street
      Hamilton HM 19, Bermuda

### Item 8.
- a) Premium: USD 125,000
- b) Minimum Earned Premium: 35%
- c) Commission: 0%

### Item 9. The Company:
Iron-Starr Excess Agency Ltd. For and on behalf of subscribing insurers as follows;
50% Ironshore Insurance Ltd.
50% Starr Insurance & Reinsurance Limited
at the address stated at the top of the Declarations Page

**Date of Issuance:** July 16, 2013
ISEABFS Non-Quota Share Declarations (06/12)