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Privacy Protection Policy

NOTICE:  THIS POLICY CONTAINS ONE OR MORE COVERAGES.  CERTAIN COVERAGES ARE LIMITED TO LIABILITY FOR CLAIMS THAT ARE FIRST MADE AGAINST YOU AND NOTIFIED TO US DURING THE POLICY PERIOD AS REQUIRED.  CLAIM EXPENSES SHALL REDUCE THE APPLICABLE LIMITS OF LIABILITY AND ARE SUBJECT TO THE APPLICABLE RETENTION(S). TERMS THAT APPEAR IN BOLD FACE TYPE HAVE SPECIAL MEANINGS.  SEE THE DEFINITIONS FOR MORE INFORMATION. PLEASE READ THIS POLICY CAREFULLY.

INSURING AGREEMENTs A,B,C,D,E,F, G, H, I OF THE POLICY PROVIDES COVERAGE ON AN INCIDENT DISCOVERED AND REPORTED BASIS; COVERAGE UNDER SUCH INSURING AGREEMENT APPLIES ONLY TO INCIDENTS FIRST DISCOVERED BY THE INSURED AND REPORTED TO THE UNDERWRITERS DURING THE POLICY PERIOD.

 

Please click on "> Authorized Officer" to open section

Authorized Officer

The officer of the Applicant that is designated to receive any and all notices from the Insurer or its authorized representative(s) concerning this insurance.

 

Please click on "> Breach Response Contact" to open section

Breach Response Contact

You or the employee of the Applicant that is designated to manage a response, including consumer notification, in response to a data breach event.

Exposure Base

For rating purposes only, Full time employees = over 30 hours per week. 1 Part time employee = .5 employee.

Please include yourself as full time.  Example 3 full time, 10 part time = 5 full time employees.

 

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

Risks over 50 employees and/or over $5,000,000 in revenues and/or non-approved business classifications are not eligible for automated calculation. Please complete the questions and submit this form for special  underwriting. Underwriters may offer alternative attachment points and different rates. You may be requested to provide additional information. 

 

Preview of your Premium Options:

You will be given the chance to choose the option you want later in the application.

 

Option 1 (Limit $500,000)

Option 2 (Limit $1,000,000)

Information Security and Privacy Controls

1. Do you use commercially available Firewall protection and Anti-Virus Protection, with regular updates and patch management?   Do you  terminate all associated computer access and user accounts as part of the regular exit process when an employee leaves the company?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

2. Do you perform regular backups of your electronic data, preferably daily and store either online or offsite?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

3. Do you process or store credit card information (where this is not outsourced to a third party that accepts full responsibility for Payment Card Industry (PCI) compliance)?

3A. Have you been certified as being PCI compliant within the last 12 months, or have successfully completed a self-assessment audit

3B. How many credit cards do you process annually?    

 3C. Do you have more than 100,000 (PII) personally identifiable information records?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

4. Does your company manage medical records or (HIPAA) protected health information?

4A. Have you conducted a review of the business to ensure compliance with all relevant HIPAA legislation?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

4B. Do you ensure that all PHI transmitted over open networks and/or stored on portable devices is encrypted.

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

Website Content Controls

5. Do you publish a website or social media page for your business?

5A. Do you agree to review the guidelines for website content risk management we will send if you bind coverage? These guidelines cover copyright infringement, libel and slander and other content hazards you need to consider.

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

Crime Coverage

6.  Prior to issuance of any funds do you or will you confirm in writing and by phone any newly changed customer or vendor identities, also any change in bank account contact or account details prior to issuance of any fund transfers?

The answers provided preclude an offer of crime coverage without further underwriting review. Premiums indicated above do not include crime coverage. If you wish to purchase coverage excluding crime please click the button below. If you prefer the underwriters to re-consider submit this application with the limits request. Underwriters may need further information and may offer non-standard limits and/or self insured retentions.

7. Do you or will you require dual authorization for funds greater than $5000 (Does not apply to sole proprietorship)? 

The answers provided preclude an offer of crime coverage without further underwriting review. Premiums indicated above do not include crime coverage. If you wish to purchase coverage excluding crime please click the button below. If you prefer the underwriters to re-consider submit this application with the limits request. Underwriters may need further information and may offer non-standard limits and/or self insured retentions.

Questions 6 and 7 do not apply to Accountants.

Prior Insurance

8. Does the Applicant currently have a stand alone Cyber protection coverage in place?

9. Have you ever been non-renewed for Cyber Protection coverage?

The answers provided preclude an offer for protection without further review. However, please use this application to submit to the Program Administrator who may request additional information and may offer alternative non-standard limits, retentions and/or other program options. 

Claims Information

10. After full inquiry, you are not aware of any circumstances, complaints, claims, loss, penalties or fines levied against you in the last three years, in relation to the risks that this application applies to?   Have you received any claims, complaints or notices of investigation with respect to privacy including ransomware attach, breach of information or network security, unauthorized disclosure of information, or defamation or infringement?

A "Yes" answer on any of the claims questions prevents the automatic calculation of an indicated premium. Please print and submit this form with additional claims information for special underwriting.

Premium

To review limits and coverage refer below to the Limits Profile and Coverage Highlights.

Limit: $1,000,000

We shall pay on Your behalf Damages and Claim Expenses that You become legally obligated to pay in excess of the applicable Retention resulting from a Claim first made against You and reported to Us during the Policy Period or Extended Reporting Period arising out of either a Security Wrongful Act, Privacy Breach or Security Breach on or after the Retroactive date and before the end of the Policy Period.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY

(includes Claim Expenses)

Option 1: $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $1,000,000

 

* SIR $5,000

We shall reimburse Your Organization for Crisis Management Costs and Breach Response Costs in excess of the applicable Retention that Your Organization incurs in the event of a Security Breach with respect to personal, non-public information. We will not make any payment under this Coverage unless the Security Breach first occurs on or after the Retroactive Date and before the end of the Policy Period and You discover the Security Breach within the Policy Period and report the Security Breach to Us as soon as practicable within the Policy Period.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)    

Option 1: $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $1,000,000

*SIR $5,000 

We shall pay on Your behalf Damages and Claim Expenses that You become legally obligated to pay in excess of the applicable Retention resulting from a Regulatory Claim first made against You and reported to Us during the Policy Period or Extended Reporting Period arising out of a Privacy Breach or Security Breach on or after the Retroactive date and before the end of the Policy Period.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY

(includes Claim Expenses)

Option 1: $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $1,000,000

*SIR $5,000 

We shall pay on Your behalf Damages and Claim Expenses that You become legally obligated to pay in excess of the applicable Retention resulting from a Regulatory Claim first made against You and reported to Us during the Policy Period or Extended Reporting Period arising out of a Privacy Breach or Security Breach on or after the Retroactive date and before the end of the Policy Period.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1: $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $1,000,000

*SIR $5,000 

We will reimburse You for any Cyber-Extortion Expenses and Cyber-Extortion Payments in excess of the applicable Retention that You actually pay directly resulting from a Cyber-extortion Threat that You first receive and report to Us during the Policy period.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1: $100,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1: $100,000

 

*Each Cyber Extortion Threat SIR $5,000 

We shall pay the Business Income and Reputational Harm Loss in excess of the applicable Retention that Your Organization sustains during a Period of Restoration resulting directly from a Network Disruption that is discovered during the Policy period, but only if the duration of the Network Disruption exceeds the Waiting Period set forth in Item 5 of the Declarations and such Network Disruption results solely and directly from a Covered Cause of Loss that commenced on or after the Retroactive date set out in Item 6. of the Declarations and before the end of the Policy period.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1:  $100,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $100,000

*SIR $5,000 

We shall pay on Your behalf Damages and Claim Expenses that You become legally obligated to pay in excess of the applicable Retention resulting from a Claim first made against You and reported to Us during the Policy period or Extended reporting period arising out of a Multimedia Wrongful Act on or after the Retroactive date set forth in Item 6. of the Declarations and before the end of the Policy period.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1:  $100,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $100,000

*SIR $5,000

We shall pay on Your behalf Damages and Claim Expenses that You become legally obligated to pay in excess of the applicable Retention resulting from a Claim first made against You and reported to Us during the Policy period or Extended reporting period arising out of a Multimedia Wrongful Act on or after the Retroactive date set forth in Item 6. of the Declarations and before the end of the Policy period.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1:  $1,000,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $1,000,000

*SIR $5,000 

We shall indemnify You for Crime Loss where Discovery occurs during the Policy Period.

PER CLAIM/BREACH SUBLIMIT OF LIABILITY (includes Claim Expenses)

Option 1:  $100,000

AGGREGATE SUBLIMIT OF LIABILITY 
(includes Claim Expenses)

Option 1:  $100,000

*SIR $5,000

We shall indemnify You for Crime Loss where Discovery occurs during the Policy Period.

Request to Bind

This document provides a non legally binding indication of potential pricing, based on the information you have provided within this application. The Company gives no representation, warranty or confirmation of protection being granted. All risks must be agreed by the Company in writing prior to any coverage being granted.

  • If you choose "Yes", please submit this application to the Program Administrator and, if accepted, issue a confirmation of my enrollment and a certificate/policy.
 
  • If you choose "No", you agree to the following:

    I understand that I have a potential exposure to a serious financial loss that is not covered by other types of Insurance.

 

Notices

NOTICE TO APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR, CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT ACT, WHICH IS A CRIME AND MAY SUBJECT SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES.

NOTICE TO ARKANSAS, NEW MEXICO AND WEST VIRGINIA APPLICANTS: ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT, OR KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON.

NOTICE TO COLORADO APPLICANTS: IT IS UNLAWFUL TO KNOWINGLY PROVIDE FALSE, INCOMPLETE, OR MISLEADING FACTS OR INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING OR ATTEMPTING TO DEFRAUD THE COMPANY. PENALTIES MAY INCLUDE IMPRISONMENT, FINES, DENIAL OF INSURANCE, AND CIVIL DAMAGES. ANY INSURANCE COMPANY OR AGENT OF AN INSURANCE COMPANY WHO KNOWINGLY PROVIDES FALSE, INCOMPLETE, OR MISLEADING FACTS OR INFORMATION TO A POLICYHOLDER OR CLAIMANT FOR THE PURPOSE OF DEFRAUDING OR ATTEMPTING TO DEFRAUD THE POLICYHOLDER OR CLAIMANT WITH REGARD TO A SETTLEMENT OR AWARD PAYABLE FROM INSURANCE PROCEEDS SHALL BE REPORTED TO THE COLORADO DIVISION OF INSURANCE WITHIN THE DEPARTMENT OF REGULATORY AUTHORITIES.

NOTICE TO DISTRICT OF COLUMBIA APPLICANTS: WARNING: IT IS A CRIME TO PROVIDE FALSE OR MISLEADING INFORMATION TO AN INSURER FOR THE PURPOSE OF DEFRAUDING THE INSURER OR ANY OTHER PERSON. PENALTIES INCLUDE IMPRISONMENT AND/OR FINES. IN ADDITION, AN INSURER MAY DENY INSURANCE BENEFITS IF FALSE INFORMATION MATERIALLY RELATED TO A CLAIM WAS PROVIDED BY THE APPLICANT.

NOTICE TO FLORIDA APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE, DEFRAUD, OR DECEIVE ANY INSURER FILES A STATEMENT OF CLAIM OR AN APPLICATION CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF A FELONY IN THE THIRD DEGREE.

NOTICE TO KANSAS APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD, PRESENTS, CAUSES TO BE PRESENTED OR PREPARED WITH KNOWEDLGE OR BELIEF THAT IT WILL BE PRESENTED TO OR BY AN INSURER, PURPORTED INSURER, BROKER OR ANY AGENT THEREOF, ANY WRITTEN STATEMENT AS PART OF, OR IN SUPPORT OF, AN APPLICATION FOR THE ISSUANCE OF, OR THE RATING OF AN INSURANCE POLICY FOR PERSONAL OR COMMERCIAL INSURANCE, OR A CLAIM FOR PAYMENT OR OTHER BENEFIT PURSUANT TO AN INSURANCE POLICY FOR COMMERCIAL OR PERSONAL INSURANCE WHICH SUCH PERSON KNOWS TO CONTAIN MATERIAL FALSE INFORMATION CONCERNING ANY FACT MATERIAL THERETO; OR CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT.

NOTICE TO KENTUCKY APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME.

NOTICE TO LOUISIANA APPLICANTS: ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON.

NOTICE TO MAINE APPLICANTS: IT IS A CRIME TO KNOWINGLY PROVIDE FALSE, INCOMPLETE OR MISLEADING INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES MAY INCLUDE IMPRISONMENT, FINES OR A DENIAL OF INSURANCE BENEFITS.

NOTICE TO MARYLAND APPLICANTS: ANY PERSON WHO KNOWINGLY AND WILLFULLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR WHO KNOWINGLY AND WILLFULLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON.

NOTICE TO MINNESOTA APPLICANTS: A PERSON WHO FILES A CLAIM WITH INTENT TO DEFRAUD OR HELPS COMMIT A FRAUD AGAINST AN INSURER IS GUILTY OF A CRIME.

NOTICE TO NEW JERSEY APPLICANTS: ANY PERSON WHO INCLUDES ANY FALSE OR MISLEADING INFORMATION ON AN APPLICATION FOR AN INSURANCE POLICY IS SUBJECT TO CRIMINAL AND CIVIL PENALTIES.

NOTICE TO NEW YORK APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME, AND SHALL ALSO BE SUBJECT TO A CIVIL PENALTY NOT TO EXCEED FIVE THOUSAND DOLLARS AND THE STATED VALUE OF THE CLAIM FOR EACH SUCH VIOLATION.

NOTICE TO OHIO APPLICANTS: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.

NOTICE TO OKLAHOMA APPLICANTS: WARNING: ANY PERSON WHO KNOWINGLY, AND WITH INTENT TO INJURE, DEFRAUD OR DECEIVE ANY INSURER, MAKES ANY CLAIM FOR THE PROCEEDS OF AN INSURANCE POLICY CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF A FELONY (365:15-1-10, 36 §3613.1).

NOTICE TO OREGON APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR, CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT ACT, WHICH MAY BE A CRIME AND MAY SUBJECT SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES.

NOTICE TO PENNSYLVANIA APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES.

NOTICE TO TENNESSEE, VIRGINIA AND WASHINGTON APPLICANTS: IT IS A CRIME TO KNOWINGLY PROVIDE FALSE, INCOMPLETE OR MISLEADING INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES INCLUDE IMPRISONMENT, FINES AND DENIAL OF INSURANCE BENEFITS.

NOTICE TO VERMONT APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR, CONCEALS, FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT ACT, WHICH MAY BE A CRIME AND MAY SUBJECT SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES.

THE UNDERSIGNED IS AUTHORIZED BY THE APPLICANT AND DECLARES THAT THE STATEMENTS SET FORTH HEREIN ARE TRUE. THE UNDERSIGNED AGREES THAT IF THE INFORMATION SUPPLIED ON THIS APPLICATION CHANGES BETWEEN THE DATE OF THIS APPLICATION AND THE EFFECTIVE DATE OF THE PROGRAM AND/OR INSURANCE, HE/SHE WILL, IN ORDER FOR THE INFORMATION TO BE ACCURATE ON THE EFFECTIVE DATE OF THE PROGRAM AND/OR INSURANCE, IMMEDIATELY NOTIFY THE PROGRAM ADMINISTRATOR OR INSURER OF SUCH CHANGES, AND THE PROGRAM ADMINISTRATOR OR INSURER MAY WITHDRAW OR MODIFY ANY OUTSTANDING QUOTATIONS OR AUTHORIZATIONS OR AGREEMENTS TO BIND THE PROGRAM AND/OR INSURANCE.  SIGNING OF THIS APPLICATION DOES NOT BIND THE APPLICANT OR THE INSURER TO COMPLETE THE INSURANCE, BUT IT IS AGREED THAT THIS APPLICATION SHALL BE THE BASIS OF THE CONTRACT SHOULD A POLICY BE ISSUED, AND IT WILL BECOME PART OF THE POLICY.   ALL WRITTEN STATEMENTS AND MATERIALS FURNISHED TO THE INSURER IN CONJUNCTION WITH THIS APPLICATION ARE HEREBY INCORPORATED BY REFERENCE INTO THIS APPLICATION AND MADE A PART HEREOF. THIS APPLICATION IS ATTACHED TO THE POLICY AT THE TIME OF ITS DELIVERY. PROVIDED, HOWEVER, THIS PARAGRAPH DOES NOT APPLY IN THE STATE OF UTAH.  Furthermore, and in respect of additional and related program deliverables, the undersigned declares that he/she understands and agrees to all of the terms and conditions provided in the Customer Agreement located at: http:// biz.identityfraud.com/pages/customer-agreement and to the following statement: In respect of the Data Risk Liability insurance, I acknowledge that the coverage is provided on a "claims made" basis. I also specifically confirm that I will or that I have read, understood and agree to my state insurance disclosure, which relates to Excess and/or Surplus Lines insurance, which in summary, states the insurance company with which the Data Risk Liability coverage is being placed is not licensed by my state and is not subject to its supervision. In the event of insolvency of the insurance company, losses under the policy will not be paid by any state insurance guaranty or insolvency fund. Additionally, the coverage is provided pursuant to my acceptance into and continued active status in the Data Theft Risk Purchasing Group and/or related RPG. I understand there may be a nominal fee of $1.00 per term paid to the RPG from the proceeds of my purchase.

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