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HISCOX <br />HISCOX INSURANCE COMPANY INC. (A Stock Company) <br />104 South Michigan Avenue, Suite 600 Chicago Illinois 60603 <br />IN WITNESS WHEREOF, the Insurer indicated above has Mused this Policy to be signed by its President and Secretary, but this Policy shall not be effective unless also <br />signed by the Insurer's duly authorized representative. <br />5� w <br />President <br />Secretary <br />4--- <br />Authorized <br />Representative <br />X?ewe:--,w6�1) 210- <br />CGL D001 01 10 Includes copyrighted material of Insurance Services Office, Inc., with Page 2 <br />its permission. 0 ISO Properties, Inc., 2000 <br />