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201 E. Fifth Street, Suite 1200 <br />Cincinnati, OH 45202 <br />Tel: 844-722-7827 <br />Fax: 513-599-7501 <br />www.corespecialty.com <br />Report claims to: <br />claims@corespecialty.com <br />TUBSTUPOF!TQFDJBMUZ!JOTVSBODF!DP/ <br />GPMMPXJOH!GPSN!FYDFTT!MJBCJMJUZ!JOTVSBODF!QPMJDZ <br />2/Zpvs!qspevdu<! <br />3/Zpvs!xpsl<!ps <br />4/Jnqbjsfe!qspqfsuz< <br />jg!tvdi!qspevdu-!xpsl!ps!qspqfsuz!jt!xjuiesbxo!ps!sfdbmmfe!gspn!uif!nbslfu!ps!gspn!vtf!cz!boz!qfstpo! <br />ps!pshboj{bujpo!cfdbvtf!pg!b!lopxo!ps!tvtqfdufe!efgfdu-!efgjdjfodz-!jobefrvbdz!ps!ebohfspvt! <br />dpoejujpo!jo!ju/ <br />O/BJSDSBGU <br />Boz!cpejmz!jokvsz!ps!qspqfsuz!ebnbhf!jodmvefe!xjuijo!uif!qspevdut.dpnqmfufe!pqfsbujpot!ib{bse!boe! <br />bsjtjoh!pvu!pg!boz!bjsdsbgu!qspevdu!ps!uif!hspvoejoh!pg!boz!bjsdsbgu/ <br />P/XBS <br />Cpejmz!jokvsz-!qfstpobm!jokvsz!ps!qspqfsuz!ebnbhf!uibu!sftvmut!gspn-!ps!boz!dpoejujpo!uibu!jt!jodjefoubm! <br />up-!boz!pg!uif!gpmmpxjoh;!)b*!xbs-!xifuifs!ps!opu!efdmbsfe<!)c*!djwjm!xbs<!)d*!!jotvssfdujpo<!)e*!sfcfmmjpo<! <br />)f*!sfwpmvujpo<!)g*!xbsmjlf!pqfsbujpot/ <br />Q/GVOHJ!PS!CBDUFSJB <br />2/Cpejmz!jokvsz-!qspqfsuz!ebnbhf-!qfstpobm!jokvsz!ps!bewfsujtjoh!jokvszxijdi!xpvme!opu!ibwf! <br />pddvssfe-!jo!xipmf!ps!jo!qbsu-!cvu!gps!uif!bduvbm-!bmmfhfe!ps!uisfbufofe!joibmbujpo!pg-!johftujpo!pg-! <br />dpoubdu!xjui-!fyqptvsf!up-!fyjtufodf!pg-!ps!qsftfodf!pg-!boz!gvohj!p s!cbdufsjb!po!ps!xjuijo!b! <br />cvjmejoh!ps!tusvduvsf-!jodmvejoh!jut!dpoufout-!sfhbsemftt!pg!xifuifs!boz!puifs!dbvtf-!fwfou-! <br />nbufsjbm!ps!qspevdu!dpousjcvufe!dpodvssfoumz!ps!jo!boz!tfrvfodf!up!tvdi!jokvsz!ps!ebnbhf<!ps <br />3/Boz!mptt-!dptu!ps!fyqfotft!bsjtjoh!pvu!pg!uif!uftujoh!gps-!npojupsjoh-!dmfbojoh!vq-!sfnpwjoh-! <br />dpoubjojoh-!usfbujoh-!efupyjgzjoh-!ofvusbmj{joh-!sfnfejbujoh!ps!ejtqptjoh!pg-!ps!jo!boz!xbz! <br />sftqpoejoh!up-!ps!bttfttjoh!uif!fggfdu!pg-!gvohj!ps!cbdufsjb-!cz!zpv!ps!boz!puifs!qfstpo!ps!foujuz/ <br />Uijt!fydmvtjpo!epft!opu!bqqmz!up!boz!gvohj ps!cbdufsjb!uibu!bsf-!bsf!po-!ps!bsf!dpoubjofe!jo-!b!gppe! <br />qspevdu!joufoefe!gps!dpotvnqujpo/ <br />Bt!vtfe!jo!uijt!fydmvtjpo-!gvohj!nfbot!boz!uzqf!ps!gpsn!pg!gvohvt-!jodmvejoh!npme!ps!njmefx!boe!boz! <br />nzdpupyjot-!tqpsft-!tdfout!ps!czqspevdut!qspevdfe!ps!sfmfbtfe!cz!gvohj/ <br />R/VOJOTVSFE0VOEFSJOTVSFE!NPUPSJTU <br />Boz!mjbcjmjuz!jnqptfe!po!uif!jotvsfe-!ps!uif!jotvsfe“t!jotvsfs-!voefs!boz!pg!uif!gpmmpxjoh!mbxt; <br />2/Vojotvsfe!npupsjtut<! <br />SSS EXS 0001 CW 03 21 Page 7 of 16 <br /> <br />