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POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM <br />INSURANCE COVERAGE <br />You are hereby notified that under the Terrorism Risk Insurance Act of 2002, as amended ("TRIA"), that you <br />now have a right to purchase insurance coverage for losses arising out of acts of terrorism, as defined in <br />Section 102(1) of the Act, as amended: The term "act of terrorism" means any act that is certified by the <br />Secretary of the Treasury, in consultation with the Secretary of Homeland Security and the Attorney General <br />of the United States, to be an act of terrorism; to be a violent act or an act that is dangerous to human life, <br />property, or infrastructure; to have resulted in damage within the United States, or outside the United States <br />in the case of an air carrier or vessel or the premises of a United States mission; and to have been committed <br />by an individual or individuals, as part of an effort to coerce the civilian population of the United States or to <br />influence the policy or affect the conduct of the United States Government by coercion. Any coverage you <br />purchase for "acts of terrorism" shall expire at 12:00 midnight December 31, 2027, the date on which the TRIA <br />Program is scheduled to terminate, or the expiry date of the policy whichever occurs first, and shall not cover <br />any losses or events which arise after the earlier of these dates. <br />YOU SHOULD KNOW THAT COVERAGE PROVIDED BY THIS POLICY FOR LOSSES CAUSED BY CERTIFIED ACTS OF <br />TERRORISM IS PARTIALLY REIMBURSED BY THE UNITED STATES UNDER A FORMULA ESTABLISHED BY FEDERAL <br />LAW. HOWEVER, YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE, <br />SUCH AS AN EXCLUSION FOR NUCLEAR EVENTS. UNDER THIS FORMULA, THE UNITED STATES PAYS 80% OF <br />COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCTIBLE PAID BY THE <br />INSURER(S) PROVIDING THE COVERAGE. YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE <br />ACT, AS AMENDED, CONTAINS A USD100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS <br />WELL AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE <br />AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS USD$100 BILLION. IF THE AGGREGATE <br />INSURED LOSSES FOR ALL INSURERS EXCEED USD$100 BILLION, YOUR COVERAGE MAY BE REDUCED. THE <br />PREMIUM CHARGED FOR THIS COVERAGE IS PROVIDED BELOW AND DOES NOT INCLUDE ANY CHARGES FOR <br />THE PORTION OF LOSS COVERED BY THE FEDERAL GOVERNMENT UNDER THE ACT. <br />BEAT-PHN-TRIA 03/2022 <br />❑ <br />1 hereby elect to purchase coverage for acts of terrorism for a prospective premium of $150 <br />❑ <br />I hereby elect to have coverage for acts of terrorism excluded from my policy. I understand that I <br />will have no coverage for losses arising from certified acts of terrorism. <br />Policy Number: <br />Effective Date: 8/15/2024 <br />Policyholder Signature: <br />Print Name: <br />Date: <br />BEAT-PHN-TRIA 03/2022 <br />