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1 MSO, Inc. 139 Harristown Road Glen Rock, New Jersey (201) (800) FAX (201) ORDER BLANK BUSINESSOWNERS PROGRAM 2007 DELAWARE, INDIANA, MAINE, MARYLAND NEW HAMPSHIRE, NEW JERSEY, NEW YORK PENNSYLVANIA & VERMONT Please limit your order to such quantities as you need for NORMAL activity Basic Form Basic Form Policy Form - Named Perils Policy Form - Named Perils / / / /08 Declarations Extension /93 BOP Change Endorsement /93 Employee Dishonesty /03 Forgery or Alterations Crime Coverage /06 Functional Replacement Condition - Coverage A Functional Replacement Condition - Coverage B (DE, MD, NH & VT ) (ME, NJ & PA) / / / /07 Landlords BOP Policy Landlords BOP Policy / /08 Indoor Glass Breakage /03 Loss Payee /01 Loss Payee - Contract of Sale /09 Landlords BOP Declarations Supplement /03 Loss Payee - Lendors Loss Payable /09 Landlords BOP Declarations Supplement Landlords BOP Declarations Supplement Landlords Expanded BOP Policy Landlords Expanded BOP Policy Landlords Expanded Declarations Supp. Landlords Expanded Declarations Supp. Landlords Expanded Declarations Supp / / / / / / /09 BOP Worksheet PART I Agreed Value Condition /01 Building Code/Law Supp. Cov. Exclusion /03 Building Code / Law Coverage - Blanket Ins. Condition /07 Business Personal Property Limitation /03 TO: On Premises Money & Securities /01 Outdoor Building Glass Cov. Deductible /03 Peak Season /03 Premises Burglary Crime Coverage (Form E) Premises Theft & Robbery Outside the Premises Coverage (Form H) Print or Type Company Address / /07 Property Not Covered /03 Protective Safeguards /03 Prot. Safeguards - Automatic Fire Alarm /03 Prot. Safeguards - Automatic Sprinkler /03 Protective Safeguards - Hood & Duct Protection /07 Computer Coverage /03 Crime Common Provisions Crime Common Provisions (ME, NH, NY & VT) / /06 Earthquake Coverage /03 ATTENTION : Municipality State Zip Code OVER > 5/21/05/21/09

2 Please limit your order to such quantities as you need for NORMAL activity Protective Safeguards - Premises Burglar Alarm /03 Theft Exclusion /03 Vacancy / Unoccupancy Extension /03 Windstorm and Related Damage Deduct. PART II Aggregate / Total Limit - Per Project (except NY) Aggregate / Total Limit - Per Location (except NY) / / /07 Asbestos Exclusion (ME & NH only) /09 Beauty / Barber Shop Prof. Liability /03 Package Stores Liquor Law Liability /03 Premises Exclusion /03 Premises Limitation /03 Premises Limitation /03 Printers Errors & Omissions Liability /07 Real Estate Agents / Brokers /03 Real Estate Property Managers Exclusion (except IN, NY & VT) Exclusion (VT only) / / /09 Computer Software Professional Activities Exclusion (except IN, NJ & NY) /07 Liability (except IN, NY & VT) /07 Condominium Association - Directors & Officers Liability (except IN, NH & NY) /07 Liability (VT only) /09 Condominium Association - Directors & Officers Liability /09 (except IN, NY & VT) /07 Condominium Association - Directors & Officers Liability - Supp. Dec. Contractors NY State Bodily Injury Limitation (except IN, NH & NY) / /07 Druggist Prof. Liability /03 Exterior Insulation & Finish System Exclusion /07 Funeral Directors Prof. Liability /03 (VT only) /09 Vacant Land /03 Veterinarian s Professional Liability /03 Volunteer and Donated Labor Medical Payments PART II : ADDITIONAL INSUREDS /07 Additional Insureds /04 Hired / Non-Owned Auto Liability (except ME & VT) /03 Additional Insureds - Supplemental Declarations /07 Incidental Professional Liability /03 Additional Insureds / Loss Payee /03 Knowledge / Notice of an Injury or Occurrence /07 Appointed / Elected Officials /07 Exclusions (ME only) Exclusion (DE, MD, & PA) Exclusion (NJ only) Lead / Lead Contamination Exclusion (DE, MD, PA & VT) / / / /07 Liquor Liability /07 Operations / Coverage Exclusion /03 Operations / Coverage Excl /06 Operations / Coverage Excl /09 Optical / Hearing Aid Services Prof. Liab /03 Architects / Engineers / Surveyors /04 Assignee / Mortgagee / Receiver /03 Blanket Additional Insureds - Contractors / Lessees / Owners /07 Charitable Institutions /07 Churches (MD only) /07 Concessionaires /07 Condominium Unit-Owner /07 Controlling Interest /03 Co-Owner of Premises /03 Executors /07 PAGE 2-5/21/09

3 BUSINESSOWNERS PROGRAM 2007 DE, IN, MD, ME, NH, NJ, NY, PA & VT Please limit your order to such quantities as you need for NORMAL activity PART II : ADD. INSUREDS (cont) Grantor of Franchise (DE, IN, MD, ME, NJ & PA) /04 BED & BREAKFAST BOP (ME, NJ & PA only) Bed & Breakfast Policy Grantor of Franchise (NH, NY & VT) /06 Lessor of Equipment /04 Managers or Lessors of Premises /03 Owners of Leased Land /03 Permits /07 Premises Permits /03 Townhouse Associations /07 Vendors /07 Volunteers /07 CONDOMINIUM Commercial Condo. Loss Assessment Coverage for Unit-Owners Commercial Condo. Improvements Coverage for Unit-Owners Commercial Condo. Improvements and Association Prop. Cov. for Unit-Owners Condominium Coverage for Condo. Associations / / / /03 Bed & Breakfast Supplemental Dec EMPLOYEE BENEFITS LIABILITY Employee Benefits Coverage Form (except NH & NY) Employee Benefits Coverage Form Supplemental Declarations (except NH & NY) Supplemental Declarations CRIME Forgery or Alterations (Form B) Premises Burglary (Form E) Premises Theft and Robbery Outside the Premises (Form H) GARAGEKEEPERS (DE, IN, MD, NJ & PA only) MCL 425 6/ /09 MCL 426 1/ /09 MCP /04 MCP 177 6/94 MCP /04 Garagekeepers Coverage Form MGK 010 4/08 Commercial Condominium Original Improvements Cov. for Unit-Owners CONDO BOP Condo Association BOP Policy Condo Association BOP Policy Condo Declarations Supplement / / / /03 Supplemental Declarations MGK 011 9/99 MISCELLANEOUS Rating / Underwriting Information Request Computer Software Professional Activities Excl. (DE, IN, MD, NY & PA) Exterior Insulation and Finish System Exclusion /97 MCL 177 6/05 MCL 178 8/00 Condo Declarations Supplement Condo Declarations Supplement / /09 TO: Print or Type Company Accounts Receivable /03 Employee Dishonesty - Condo /03 HOME BUSINESS (except NY) Home Business Policy /07 Address Municipality State Zip Code Home Business Supplemental Dec /03 ATTENTION : Home Business Supplemental Dec /109 OVER > PAGE 3-5/21/09

4 Please limit your order to such quantities as you need for NORMAL activity Fungi / Mold Exclusions (NJ only) MCL 183 1/02 Exclusion (DE, IN, MD & PA only) Exclusion (NJ only) Exclusion Liability Liability Contractors New York State Bodily Injury Limitation Knowledge / Notice of Injury or Occurrence Blanket Additional Insured Additional Insureds - Supplemental Dec. Liquor Liability Condominium Assoc. Directors & Officers Liability Condominium Assoc. Directors & Officers Liability - Supplemental Dec. MCL 187 4/07 MCL 189 4/07 MCL 191 6/02 MCL 192 6/02 MCL /05 MCL 193 6/05 MCL 205 6/05 MCL 328 7/04 MCL 350 5/00 MCL 422 6/05 MCL 427 6/05 MCL /98 Year 2000 Exclusion Year 2000 Exclusion / Notice to Policyholders Certified Terrorism Loss Coverage (ME, NH & NJ) (DE, MD, PA, VT; NJ - only applies to risks with over $10,000 premium) (IN only) Certified Terrorism Loss Cov. Disclosure (except IN) Certified Terrorism Loss Cov. Disclosure (IN only) Terrorism Exclusions (ME, NH & NJ) Terrorism Exclusions (DE, MD, PA & VT; NJ - only applies to risks with over $10,000 premium)) Terrorism Exclusions (IN only) Exclusions (ME, NH & NJ) MCM 400 3/98 MCM 400 PN 3/98 MCM 411 1/08 MCM 412 1/08 MCM 413 1/08 MCM 413 1/05 MCM 414 1/08 MCM 414 2/03 MCM 416 1/08 MCM 417 1/08 MCM 417 1/05 MCM 418 1/08 Printers Errors and Omissions Real Estate Property Manager Aggregate / Limit - Per Project Aggregate / Total Limit - Per Location (NJ & PA only) (DE, IN & MD only) MCL 429 1/00 MCL 429 7/06 MCL 434 8/00 MCL 435 6/05 MCL 601 4/98 MCL 602 5/98 MCP 140 5/05 MCP 141 5/05 Exclusions (DE, MD, PA & VT; NJ - only applies to risks with over $10,000 premium) Exclusions (IN only) MCM 419 1/08 MCM 419 1/05 Certified Terrorism Coverage MCM 861 1/08 INLAND MARINE (DE, IN, MD, NJ, NY & PA only) MCM 862 1/08 Common Provisions Form MIM 010 6/07 Supplemental Declarations (scheduled) MIM /96 Installation Floater - Supplemental Dec. MIM /97 Supplemental Declarations MIM 013 5/99 Hood and Duct Protection MCP 242 4/98 Declarations Extension MIM 019 6/07 Building Code / Law Blanket Ins. Cond. Windstorm and Related Damage Ded. MCP 250 1/05 MCP 251 1/05 Computer Coverage - used with MIM 010 MIM 101 2/00 Computer Hacking / Virus Exclusion MIM 102 4/07 Computer Hacking / Virus Limitation MIM 103 4/07 PAGE 4-5/21/09

5 BUSINESSOWNERS PROGRAM 2007 DE, IN, MD, ME, NH, NJ, NY, PA & VT Please limit your order to such quantities as you need for NORMAL activity Fine Arts MIM /96 Installation MIM 111 6/07 Miscellaneous Property MIM /96 Musical Instruments MIM /96 Photographic Equipment MIM /96 Physicians and Surgeons Equipment MIM 115 6/07 Transit MIM 116 2/97 Antique Dealers Coverage MIM 117 4/99 Contractors Tool MIM 120 6/07 Contractors Tool - Supplemental Dec. MIM 121 1/98 Builders Risk MIM 130 6/07 Builders Risk - Supplemental Dec. MIM 131 6/07 Indiana Mandatory Endorsement MCM 832 5/03 Mine Subsidence MCP 802 1/99 Account Modification Supplement MSO-AMS 1998 Account Modification Summary AMS Maine Declarations Supplement /09 Certified Terrorism Loss Coverage (DE, MD, NJ & PA) Certified Acts of Terrorism Exclusion (DE, MD, NJ & PA) Terrorism Excl. (DE, MD, NJ & PA) Exclusion (DE, MD, NJ & PA) Certified Terrorism Loss Coverage Certified Acts of Terrorism Exclusion MIM 140 1/08 MIM 141 1/08 MIM 142 1/08 MIM 143 1/08 MIM 840 1/08 MIM 841 1/08 Mandatory Endorsement /09 Mandatory Endorsement Condominium Associations /09 Standard Fire Provisions MCP 804 2/09 Account Modification Supplement MSO-AMS 2008 Account Modification Summary AMS Mandatory Endorsement MIM 860 9/05 STATE SPECIFIC FORMS Delaware Mandatory Endorsement /07 TO: Print or Type Company Uninsured / Underinsured Motorists Coverage - Mobile Equipment MCM 831 6/05 Address Municipality State Zip Code Account Modification Supplement MSO-AMS 5/83 ATTENTION : Account Modification Summary AMS 002 5/83 OVER > PAGE 5-5/21/09

6 Please limit your order to such quantities as you need for NORMAL activity Maryland Mandatory Endorsement /07 Waiver - Lead / Lead Contamination Excl /07 Waiver - Lead / Lead Contamination Excl. MCL 210 6/05 Uninsured / Underinsured Motorists Coverage - Mobile Equipment MCM 841 6/05 Account Modification Supplement MSO-AMS 1998 Account Modification Summary AMS New Hampshire Declarations Supplement /09 Declarations Supplement (Named Perils) /09 New York Declarations Supplement /06 Declarations Supplement (Named Perils) /06 Declarations Extension - Endorsement Description /06 Mandatory Endorsement /09 Asbestos Exclusion MCL /05 Lead / Lead Contamination Exclusion MCL /05 Corporal Punishment Laibility MCL 807 6/05 Volunteer Fire Fighters Injury Exclusion MCL 808 6/05 Employee Benefits Liability Coverage MCL 825 8/06 Employee Benefits Supplemental Decl. MCL /06 Pennsylvania Mandatory Endorsement /07 Mandatory Condominium Association Endorsement /03 Declarations Extension - Endorsements Description /08 Uninsured / Underinsured Motorists Coverage - Mobile Equipment MCM 815 6/05 Mandatory Endorsement /09 Liquor Liability - Temporary Licenses MCL 413 6/05 Liquor Liability - Designated Activities MCL 414 6/05 Liquor Law Liability MCL 415 5/97 New Jersey Mandatory Endorsement /07 Fungi / Mold Limitations /07 Fungi / Mold Limitations /07 Fungi / Mold Limitations MCL 883 8/02 Fungi / Mold Limitations - Notice to Policyholders MCN 883 8/02 Fungi / Mold Limitations MCL 884 4/03 Uninsured / Underinsured Motorists - Mobile Equipment MCM 827 6/05 Account Modification Supplement MSO-AMS 1998 Account Modification Summary AMS Vermont Declarations Supplement /09 Declarations Extension - Endorsements Description /08 Mandatory Endorsement /09 Mandatory Endorsement /09 Account Modification Supplement MSO-AMS 2008 Account Modification Summary AMS BOP Application Commercial Insurance Rating Plan CIRP 001 6/91 PAGE 6-5/21/09