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Page 1 of <br /> <br /> <br /> <br /> <br />Extended Declarations Page <br />ISSUED BY: . <br />NAMED INSURED: <br />POLICY NUMBER: <br />POLICY PERIOD: <br />STATE SURPLUS LINES REQUIRED WORDING: <br />1 <br />IMPORTANT NOTICE: <br />1. The insurance policy that you have purchased is being issued by <br />an insurer that is not licensed by the State of California. These <br />IUSVGTOKY GXK IGRRKJ bTUTGJSOZZKJc UX bY[XVR[Y ROTKc OTY[XKXY( <br />2. The insurer is not subject to the financial solvency regulation <br />and enforcement that apply to California licensed insurers. <br />3. The insurer does not participate in any of the insurance <br />guarantee funds created by California law. Therefore, these funds <br />will not pay your claims or protect your assets if the insurer becomes <br />insolvent and is unable to make payments as promised. <br />4. The insurer should be licensed either as a foreign insurer in <br />another state in the United States or as a non-United States (alien) <br />insurer. You should ask questions of your insurance agent, broker, or <br />bY[XVR[Y ROTKc HXUQKX UX IUTZGIt the California Department of <br />Insurance at the toll-free number 1-800-927-4357 or internet website <br />www.insurance.ca.gov. Ask whether or not the insurer is licensed as <br />a foreign or non-United States (alien) insurer and for additional <br />information about the OTY[XKX(EU[ SG_GRYU \OYOZ ZNK>5:6dYOTZKXTKZ <br />website at www.naic.org. The NAICathe National Association of <br />Insurance Commissionersais the regulatory support organization <br />created and governed by the chief insurance regulators in the United <br />States. <br />5. Foreign insurers should be licensed by a state in the United <br />BZGZKY GTJ _U[ SG_ IUTZGIZ ZNGZ YZGZKdY JKVGXZSKTZ UL OTY[XGTIK ZU <br />obtain more information about that insurer. You can find a link to <br />each state from this NAIC internet website: <br />https://naic.org/state_web_map.htm. <br />6. For non-United States (alien) insurers, the insurer should be <br />licensed by a country outside of the United States and should be on