# DECLARATIONS, cont’d

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

a) All Notices of Occurrence, Claim or Loss:

To:
- Via Email: Highexcessclaims@aig.com
- Via Easy-Link Fax: 877-839-9721
- Via mail to:
  AIG – Cat Excess Liability Claims
  PO Box 2430
  Alpharetta, GA 30023-2430, USA

b) All other Notices:

To:
- American International Reinsurance Company, Ltd.
  27 Richmond Road
  Pembroke, HM08
  Bermuda
  Att: Cat Excess Liability Underwriting

**Item 8.**
a) Premium: USD 100,000 (for 100% Flat Annual)
b) Minimum Earned Premium: USD 35,000
c) Commission: 0%

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

**Item 10. Policy Form: Endorsements**
The Bermuda Shorts Form – 03 (Ed. 03/14)
1 -5 at Policy Issuance

**Date of Issuance:** July 7, 2014

**Authorized Representative**

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