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Technology Form - ACE Group

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B. Regulatory Proceeding Sub-Limit of Liability $ $Item 5.Item 6.C. Maximum Policy Aggregate Limit of Liability: $Retention:$ each Claim for Coverages A, B, C, D and G (if selected)$ each Claim for Coverage E (if selected)$ each Claim for Coverage F (if selected)Notice to Insurer:A. Notice of Claim, Wrongful Act, or Network Extortion Threat:Director of Claims[Company][Address][Address]B. In the event of a Network Extortion Threat where urgent crisis management support isrequired, please contact:C. All other notices:<strong>ACE</strong> USA Professional Risk Claims Hotline: 1 (800) 523-9254Chief Underwriting Officer[Company][Address][Address]Item 7. Policy Premium: $Item 8. Miscellaneous Professional Services (applicable only to Coverage G, if selected):Item 9.Optional Extended Reporting Period:A. Additional Premium: ____% of Annual PremiumB. Additional Period: _____________________________Item 10. Retroactive Date:A. <strong>Technology</strong> and Internet Errors and Omissions Liability ____________B. Electronic Media Activities Liability ____________C. Network Security Liability ____________D. Privacy Liability ____________E. Data Breach Fund ____________F. Network Extortion Threat ____________G. Miscellaneous Professional Services Liability ____________IN WITNESS WHEREOF, the Insurer has caused this Policy to be countersigned by a duly authorized representative of theInsurer.DATE: ______________________________________________________________________________________Authorized RepresentativePF-26996 (05/09) © 2009 Page 2 of 2

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