| Item 6. | Underlying Limits: (Insuring Agreement 2): |
| --- | --- |
| a) | USD 550,000,000 each Occurrence, Claim or Loss |
| b) | USD 550,000,000 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: | Claims Department Chubb Bermuda Insurance Ltd. 17 Woodbourne Avenue Hamilton HM 08 Bermuda Facsimile: 441-292-2456 E-mail: bermudaclaimsnoces@chubb.com |
| b) | All other Notices: |
| To: | Underwriting Department Chubb Bermuda Insurance Ltd. 17 Woodbourne Avenue Hamilton HM 08 Bermuda Facsimile: 441-296-7796 |

| Item 8. | a) Gross Premium: | b) Minimum Earned Premium: | c) Commission: |
| --- | --- | --- | --- |
| | USD 99,000.00 (For 100% Flat Annual) | NONE | USD 0.00 |

| Item 9. | The Company: | Chubb Bermuda Insurance Ltd. At the address stated in Item 7 of the Declarations Page |

| Item 10. | Policy Form: Endorsements: | The Bermuda Shorts Form – BSF-03 (Ed. 03/14) 1 to 4 at Policy Issuance |
| --- | --- | --- |
| | End. 001 001-04/14 Schedule of Excess Policy(ies) Endorsement | |
| | End. 002 004-04/14 Premium Payment Condition Endorsement | |
| | End. 003 008-04/14 Following Form Policy Issuance Endorsement | |
| | End. 004 048-12/15 Cancellation Endorsement | |

**IN WITNESS WHEREOF**, this Policy has been made, entered into and executed by the undersigned in Hamilton, Bermuda this 24<sup>th</sup> day of August, 2016.

By: **Authorized Representatives**

BSF-03