**ZURICH INTERNATIONAL RISK DATA SHEET**

**POLICY NO:** 72-966-37-C

**LAYERS SECTION**

| Layer | X/S | Premium | Premium Per Million | Adjustment |
|-------|-----|---------|---------------------|-------------|
| 1     | 25.00 | 55.00 | 250,000.00 | 10,000.00 | N |

**Z 008755**