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AM <br />H ISCOX <br />Hiscox Insurance Company Inc. <br />ECONOMIC AND TRADE SANCTIONS POLICYHOLDER NOTICE <br />Hiscox is committed to complying with the U.S. Department of Treasury Office of Foreign Assets Control (OFAC) <br />requirements. OFAC administers and enforces economic sanctions policy based on Presidential declarations of <br />national emergency. OFAC has identified and listed numerous foreign agents, front organizations, terrorists, and <br />narcotics traffickers as Specially Designated Nationals (SDN's) and Blocked Persons. OFAC has also identified <br />Sanctioned Countries. A list of Specially Designated Nationals, Blocked Persons and Sanctioned Countries may be <br />found on the United States Treasury's web site http://www.treas.gov/offices/enforcement/ofac/. <br />Economic sanctions prohibit all United States citizens (including corporations and other entities) and permanent <br />resident aliens from engaging in transactions with Specially Designated Nationals, Blocked Persons and Sanctioned <br />Countries. Hiscox may not accept premium from or issue a policy to insure property of or make a claim payment to a <br />Specially Designated National or Blocked Person. Hiscox may not engage in business transactions with a Sanctioned <br />Country. <br />A Specially Designated National or Blocked Person is any person who is determined as such by the Secretary of <br />Treasury. <br />A Sanctioned Country is any country that is the subject of trade or economic embargoes imposed by the laws or <br />regulations of the United States. <br />In accordance with laws and regulations of the United States concerning economic and trade embargoes, this policy <br />may be rendered void from its inception with respect to any term or condition of this policy that violates any laws or <br />regulations of the United States concerning economic and trade embargoes including, but not limited to the following: <br />(1) Any insured under this Policy, or any person or entity claiming the benefits of such insured, who is or becomes <br />a Specially Designated National or Blocked Person or who is otherwise subject to US economic trade <br />sanctions; <br />(2) Any claim or suit that is brought in a Sanctioned Country or by a Sanctioned Country government, where any <br />action in connection with such claim or suit is prohibited by US economic or trade sanctions; <br />(3) Any claim or suit that is brought by any Specially Designated National or Blocked Person or any person or <br />entity who is otherwise subject to US economic or trade sanctions; <br />(4) Property that is located in a Sanctioned Country or that is owned by, rented to or in the care, custody or control <br />of a Sanctioned Country government, where any activities related to such property are prohibited by US <br />economic or trade sanctions; or <br />(5) Property that is owned by, rented to or in the care, custody or control of a Specially Designated National or <br />Blocked Person, or any person or entity who is otherwise subject to US economic or trade sanctions. <br />Please read your Policy carefully and discuss with your broker/agent or insurance professional. You may also visit the <br />US Treasury's website at http://www.treas.gov/offices/enforcement/ofac/. <br />INT N001 CW 0109 <br />XIAMPw&t tDwutm <br />74 d <br />RiPk.Ma,ugenwv,P fJcrkal Nde <br />