PRIVATE CLIENT GROUP American Home Assurance Co. Renewal (Name of issuing company) Homeowners Declarations Page Your Declarations Page shows at a glance the coverage you have and your premium. Your Declarations Page is part of your policy. Please read your policy carefully, including your Declarations Page and any attached Endorsements, for a description of your coverage. Policy Number: PCG 0002406962 CHARTISC Name of Insured and Mailing Address: Jeffrey E. Epstein 301 East 66th Street Suite 10F New York• NY 10065 Effective: 07/15/2011 Policy Period: 07/15/2011 - 07/15/2012 Al 12 01 A M. 0ar4md Irmo ed you. random; addocm clgwn ImIow Agency Name. Address, Phone # & Code: Insurance Office Central Ohio P.O. Box 780 New Albany, OH 43054 (614) 939.5471 0050519 YOU WILL BE BILLED BY YOUR BROKER FOR ANY PREMIUM DUE. The kind of losses that are covered and any special limits or deductibles that apply, are explained in detail in your Policy. Summary of Coverage by Location: 358 El Brillo Way Palm Beach, FL 33480 COVERAGE PAYMENT BASIS COVERAGE LIMIT House Extended Rebuilding Cost $4,909,785 Other Permanent Structures Extended Rebuilding Cost $981,957 Contents Replacement Cost $2,454,893 Loss of Use S1,472,936 Liability 8300,000 Medical Payments $10,000 Rebuilding to Code (Law and Ordinance - 30%) $1,472,936 Citizens Property Insurance Corporation Emergency Assessment: $349.24 Florida Hurricane Catastrophe Fund Emergency Assessment: 5349.00 Emergency Management. Preparedness, and Assistance Trust Fund: 52.00 Location Premium: 835,815.24 Deductible applied to this location: Standard (All Other Perils): 525,000 Hurricane Deductible: S98,196 (2% of House coverage) THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE OR WIND LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. Total Citizens Emergency Assessment: $349.24 Total Florida Hurricane Catastrophe Fund Emergency Assessment: $349.00 PCHO.DEC•F