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r*J <br />StarStone <br />Fan or khe C (Ne S sCl;q Getup <br />STARSTONE SPECIALTY INSURANCE CO. <br />201 E. Fifth Street, Suite 1200 <br />Cincinnati, CH 45202 <br />Tel: 844-722-7827 <br />Fax: 513-599-7501 <br />www.coresr)ecialtv.com <br />Report claims to: <br />claims@corespecialty.com <br />FOLLOWING FORM EXCESS LIABILITY INSURANCE POLICY <br />2. Underinsured motorists; <br />3. Auto no-fault laws or other first party personal injury laws; or <br />4. Medical expense benefits and income loss benefits laws of any applicable state or jurisdiction. <br />R. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM <br />With respect to any one or more certified acts of terrorism, we will not pay any amounts for which <br />we are not responsible under the terms of the federal Terrorism Risk Insurance Act of 2002 (including <br />subsequent acts of Congress pursuant to the Act) due to the application of any clause which results <br />in a cap on our liability for payments for terrorism losses. <br />Certified act of terrorism means an act that is certified by the Secretary of the Treasury, in <br />concurrence with the Secretary of State and the Attorney General of the United States, to be an act of <br />terrorism pursuant to the federal Terrorism Risk Insurance Act of 2002 as amended and extended by <br />the Terrorism Risk Insurance Program Reauthorization Act of 2007. The federal Terrorism Risk <br />Insurance Act of 2002 as amended and extended by the Terrorism Risk Insurance Program <br />Reauthorization Act of 2007 sets forth the following criteria for a certified act of terrorism: <br />1. The act resulted in aggregate losses in excess of $ 100 million; and <br />2. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is <br />committed by an individual or individuals acting part of an effort to coerce the civilian population <br />of the United States or to influence the policy or affect the conduct of the United States <br />Government by coercion. <br />S. LIMITED TERRORISM EXCLUSION (OTHER THAN CERTIFIED ACTS) <br />Damages arising, directly or indirectly, out of any act of terrorism other than a certified act of <br />terrorism. <br />T. PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OF TERRORISM <br />Damages arising, directly or indirectly, out of a certified act of terrorism that are awarded as <br />punitive damages. <br />SSS EXS 0001 CW 03 21 Page 8 of 16 <br />