| Item 6. | Underlying Limits: (Insuring Agreement 2): | USD200,000,000 | Aggregate |
| --- | --- | --- | --- |
|  | a) | USD200,000,000 | Each Occurrence |
|  | b) | USD200,000,000 | 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 Allied World Assurance Company, Ltd. 27 Richmond Road Pembroke HM 08 Bermuda Telephone: (441) 278-5400 Fax No. (441) 296-3428 GenCasClaims@awac.com |
|  |  | b) | All other Notices: |
|  |  | To: | Underwriting Department Allied World Assurance Company, Ltd. 27 Richmond Road Pembroke HM 08 Bermuda Telephone: (441) 278-5400 Fax No.(441) 296-3428 |
| Item 8. | a) Premium: | USD66,750 |  |
|  | b) Minimum Earned Premium: | USD23,363 |  |
|  | c) Commission: | 0% |  |
| Item 9. | The Company: |  |  |
| Item 10. | Policy Form: Endorsements | The Bermuda Shorts Form – 03 (Ed. 03/14) 1 - 4 at Policy Issuance |  |
| Date of Issuance: August 24, 2016 ACBSF-03 (03/14) |  | Page 2 of 10 |