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1r <br />StarStone <br />Ped of the Care Spa€my Croup <br />STARSTONE SPECIALTY INSURANCE CO. <br />201 E. Fifth Street, Suite 1200 <br />Cincinnati, OH 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 />exhaustion of the underlying aggregate limits, and the Insured shall retain liability for any resulting <br />gap in coverage. <br />I. SERVICE OF SUIT <br />Pursuant to any statute of any state, territory or District of the United States which makes provision <br />therefore, the Insurer hereby designate the Superintendent, Commissioner or Director of Insurance or <br />other officer specified for that purpose in the statute, or his successor or successors in office, as its <br />true and lawful attorney upon whom may be served any lawful process in any action, suit or <br />proceeding instituted by or on behalf of the insured or any beneficiary hereunder, arising out of this <br />Policy. <br />IN WITNESS WHEREOF, the Insurer has caused this Policy to be signed by its Authorized <br />Representative and countersigned on the Declarations Page by a dully authorized agent of the Insurer. <br />President <br />Secretary <br />SSS EXS 0001 CW 03 21 Page 16 of 16 <br />