Mrshall INSURANCE General Liability Insurance Renewal Proposal Underwritten by certain underwriters at Lloyd's (BRT) For Financial Trust Company, Inc. Page 2 of 2 The coverage in this proposal is of course subject to further terms, conditions and exclusions that will be contained in the policy documents. Total Annual Premium: $3249.17 Including lax Terrorism Coverage Premium: $177.01 including tax THIS QUOTE IS VALID UNTIL: 06/29/12 Stop Gap Premium: $505.00 including tax Check appropriate box for desired coverage: I I 1 accept the certain underwriters at Lloyd's General Liability Proposal excluding terrorism coverage I accept the certain underwriters at Lloyd's General Liability Proposal including terrorism coverage I I Accept the Stop Gap Insurance for the additional premium noted above Signature: Date: Az_ EFTA01221758