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DocuSign Envelope ID: D36FCB7D-OE56-4E5C-A96E-7CO5705C56F9 <br /> PRO GUARD PLATINUM POLICY DECLARATIONS (continued) <br /> ITEM 6. FORMS AND ENDORSEMENTS <br /> Forms and Endorsements applying to this Coverage Part and made part of the Policy at time of issue: <br /> SEE SCHEDULE OF FORMS AND ENDORSEMENTS AND <br /> THE INSURED's APPLICATION FOR THIS INSURANCE. <br /> THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY <br /> PERIOD. <br /> WESTERN WORLD INSURANCE GROUP <br /> Western World Insurance Company <br /> Tudor Insurance Company <br /> Stratford Insurance Company <br /> Administrative Office <br /> 300 Kimball Drive, Suite 500 <br /> Parsippany, New Jersey 07054 <br /> We will provide the insurance described in this policy in return for the premium and compliance with all applicable <br /> provisions of this policy. If required by state law, this policy shall not be valid unless countersigned by our authorized <br /> representative. <br /> Secreta President <br /> Countersigned: <br /> • <br /> • <br /> 09/16/2019 PECKISAA By: <br /> Authorized Representative <br /> Page 2 of 2 MPL 2002(05_18) <br />