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<br />Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 <br /> P.O. Box 2002 Fax 860.408.2002 <br /> Simsbury, CT 06070-7683 <br />PREMIUM SUMMARY: <br /> <br /> <br />Option 1: <br /> <br /> $813. Directors & Officers Liability and Entity Liability <br /> $892. Employment Practices Liability <br /> <br /> $1,705. POLICY TOTAL <br /> <br /> <br /> <br /> <br />Option Information: <br /> <br /> <br /> <br />POLICY COMMISSION: 20% <br /> <br /> <br />BILLING TYPE: Direct Bill <br /> <br /> <br /> <br />CONTINGENCIES: The above quote is expressly contingent upon receipt, review and acceptance of the subjectivities listed <br />below. We must receive all of the items identified below on or before the Quotation Expiration date shown below. If all of <br />these items are not received and approved by us on or before this date, this quote will automatically expire without further <br />action or notice. <br /> <br />Nothing is required at this time. <br /> <br /> <br />IMPORTANT <br />The foregoing quotation for coverage is subject to modification or withdrawal by the Company if, before the proposed inception <br />date, any new, corrected or updated information becomes known which relates to any proposed Insured’s claims history or risk <br />exposure or which could otherwise change the underwriting evaluation of any proposed Insured, and the Company, i n its sole <br />discretion, determines that the terms of this quotation are no longer appropriate. <br /> <br />This proposal does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from <br />offering or providing insurance. To the extent any such prohibitions apply, this proposal is void ab initio. <br /> <br />Quotation Expiration: October 30, 2020 <br /> <br />Notes: <br /> <br /> <br /> <br />If you have any questions, please call me at (860) 408 -2594 <br /> <br />Kelly Mercey <br />Underwriter <br />Fax Number: (555) 555-5555 <br />Email Address: Kelly.Mercey@Chubb.com <br /> <br />DocuSign Envelope ID: 010D91E2-5C66-4610-B0AF-F96D7E61B6C5