**BLANKET EXCESS LIABILITY POLICY**

**POLICY NUMBER:** XLX-1364370
**EXPIRATION DATE:** 3-20-80
**POLICY NUMBER:** XLX-1370350

**DECLARATIONS:**

* **Insured:** [Name of Insured]
* **Effective Date:** 3-21-79
* **Expiration Date:** 3-21-80
* **Item 3 - Limit of Liability:**
    * Each Occurrence: $10,000,000
    * Aggregate: $10,000,000
    * Policy Maximum: $40,000,000
* **Item 4 - Total Insurance:**
    * Each Occurrence: $40,000,000
    * Aggregate: $40,000,000
* **Item 5 - Premium Basis:**
    * Flat Change
* **Item 6 - Advance Premium:**
    * $16,893
* **Item 7 - Schedule of Underlying Insurance:**
    * See Endt #2

**FOLLOWING FORM BLANKET EXCESS LIABILITY POLICY**

The Company, an insurance company, agrees with the insured to indemnify for the insured's ultimate net loss under the blanket excess liability policy. The policy applies only to occurrences that take place during the policy period.

**INSURING AGREEMENTS:**

1. The Company shall be liable only for the limit of liability stated in Item 3 of the Declarations.
2. The limit of liability is the total limit of the Company's liability for all damages sustained during each annual period of this policy.
3. Policy Period: This policy applies only to occurrences which take place during the policy period.

**DEFINITIONS:**

* Ultimate net loss means all sums actually paid or which the Insured is legally obligated to pay as damages in settlement or satisfaction of a claim or suit for which insurance is afforded by this policy, after proper deduction of all recoveries or salvage.

**CONDITIONS:**

* Maintenance of Primary Insurance: The Insured warrants and it is a condition of this policy that at the inception of this policy, the primary insurance afforded by the underlying policies of insurance (copied) is in full force and effect.

**COUNTERSIGNATURE OF AUTHORIZED AGENT:**

[Signature]

**PAGE ONE**

**ENDT #2:**

* **Underlying Insurance Limit of Liability:**
    * Each Occurrence: $40,000,000
    * Aggregate: $40,000,000
* **Premium Basis:**
    * Flat Change
* **Advance Premium:**
    * $16,893
* **Annual Minimum Premium:**
    * $16,893