# National Union Fire Insurance Company of Pittsburgh, PA

**POLICY NO.:** [Not specified]

The Company agrees with the Insured named below, in consideration of the premium paid and subject to all the terms and conditions set forth below that the insurance afforded by this policy shall follow all the terms and conditions of Policy Number [Not specified], issued by [Not specified] including all renewals and rewrites thereof.

**NAMED INSURED:** [Not specified]
**ADDRESS:** [Not specified]
**POLICY PERIOD:** [Not specified]
**COVERAGE:** [Not specified]
**LIMIT OF LIABILITY:** [Not specified]
**PREMIUM:** [Not specified]
**RATE:** [Not specified]

IN WITNESS WHEREOF, the Company has caused this policy to be signed by its President and Secretary at New York, New York and countersigned by a duly authorized representative of the Company.

**[Signatures]**

**Countersigned by:** [Not specified]