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SUNNYISLES 1703779 City of Sunny Isles Beach • PROPOSAL CONDITIONS This proposal has been prepared on the premise: - there are no known uninsurable individuals in the group to be covered; - no employee is absent from work because of sickness or injury. If any individual to be insured falls into the above categories, we will require full disclosure of all necessary information to evaluate the risk. After reviewing this information, we reserve the right to revise or withdraw our quotation. To become insured, an eligible employee must be an active, full -time employee who: - is a member of an eligible class of employees; - has completed the eligibility waiting period established by the employer; - is not a temporary or seasonal employee; - is performing all customary duties of his /her occupation at his /her usual place of business on the policy effective date (or on the effective date of his /her coverage); and - is regularly scheduled to work at least 30 hours per week, unless otherwise agreed upon by Jefferson Pilot Financial Insurance Company. If included, any eligible dependents must satisfy a nonconfinement requirement on the policy effective date (or on the date coverage becomes effective). This proposal is based on the assumption that the current insurance carrier will continue coverage on any insured individual who is disabled on the date the existing contract terminates (even if it terminates while a 4 Isabled person is satisfying any applicable waiting period). The rates quoted in this proposal are a function of the characteristics of the group (i.e.: Policyholder contributions, occupations, age, gender, etc.) and the benefits requested at the time of proposal submission. If the plan is non - contributory, 100% of the eligible employees must enroll; and if the plan is contributory, 75% of the eligible employees must enroll on the effective date. We reserve the right to re- evaluate the risk, and revise or withdraw our quotation if necessary, based upon the characteristics of the group and the benefits provided on the effective date of the plan. This proposal is a description of insurance coverages available from Jefferson Pilot Financial and is not an offer to contract. An application must be completed before a group will be considered for coverage. This proposal outlines in general some of the important features of the proposed Group Insurance Program. The controlling provisions will be in the Group Insurance Policy, and this proposal is not intended in any way to modify the provisions or their meanings. This proposal will remain in effect until withdrawn or a new proposal is issued by Jefferson Pilot Financial, but in no event will this proposal remain in effect beyond 90 days from November 16, 2001. is FL Jefferson Pilot Financial Insurance Company 5 11/16/2001