NOTICE. You must be a currently contracted agent/broker of Infinity Insurance Group to be eligible for enrollment in this E&O program.

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1 NOTICE You must be a currently contracted agent/broker of Infinity Insurance Group to be eligible for enrollment in this E&O program. If you enroll in this program and you do not have an ACTIVE contract with Infinity Insurance Group you will NOT be considered an insured and claims reported will not be covered. InfinityDisclosureNotice_CA_122208v1 (dba CalSurance Brokerage in New York Page 1 of 7

2 CalSurance & Infinity Are Pleased To Announce New Low Rates For Those Firms Who Qualify For The California Select Program! To Enroll: Online: Manually: Complete the attached Enrollment & Election Form on page 6 of this packet. Once you have completed your On-Line Enrollment, coverage is automatically bound. * The information obtained from A.M. Best dated 11/13/07 is not in any way CalSurance's warranty or guaranty of the financial stability of the insurer in question, and that the information is current only as of the date of the publication. P.O. Box 7048, Orange, CA Customer Care Unit: Monday to Friday 7:00am to 5:00pm (PST) Phone: (800) Fax: (800) CalSurance E&O Group Specialists Insurance Agency Professional Liability Insurance for Infinity Agents and Brokers California Select Program he Infinity Insurance Group Sponsored E&O Program provides broad coverage and various limit options to those insurance Tagencies with a current Infinity Insurance appointment. Coverage is to be provided by the American Automobile Insurance Company, a Fireman's Fund Insurance Company with an A.M. Best Rating of A (Excellent), XV.* If your California agency fits the below criteria, you are eligible for automatic enrollment in the Infinity California Select program. You may enroll online at or if you do not have web access, you can complete the attached enrollment packet. If your agency does not fit the below criteria you may be eligible for the Infinity California Standard program. Please call CalSurance Customer Care at: or visit for more details. Your agency qualifies for Automatic Enrollment in the California Select Program if your agency or brokerage meet the following criteria: Basic Coverage 1. Agencies with five (5) or less licensed staff; and annual commissions of $1,500,000 or less; 2. Agencies with no pending or prior E&O claims in the past five (5) years; 3. Agency's principals, officers and/or employees have never been the subject of a complaint, reprimand or disciplinary or criminal action by any federal, state or local authorities as a result of their professional services; 4. Agency has been in business under the current ownership for three (3) years or more; and Agency has not acquired the assets and liabilities of another agency in the past three (3) years; 5. At least 60% of the annual Agency commissions are derived from the sale of Personal Lines, Property & Casualty insurance products; 6. Less than 10% of the total fixed annuity sales is derived from fixed, deferred annuity sales to Seniors (65 years or older) 7. No more than 10% of total revenues is derived from business placed with unrated carriers, or admitted carriers rated less than B+ by A.M. Best, or non-admitted carriers rated less than A- by A.M. Best; 8. The agency does not operate as an MGA, wholesaler, surplus lines broker, real estate agent/broker or claims TPA; 9. The agency does not own, operate, manage, administer or place business in Alternative Risk Transfer arrangements; Captives, Risk Retention Groups, Risk Purchasing Groups, Professional Employer Organizations (PEOs) or partially or wholly self insured groups or trusts. If electing Financial Products Coverage Variable Products/Mutual Funds (Level I or Level II - $1,000,000 Sublimit) 1. Your agency derives no more than 10% of revenues from the sale/servicing of Variable Life, Variable Annuities, Mutual Funds or any related financial planning activities InfinityFlyers_CASelect_123008v5 Page 2 of 7

3 Program Highlights Insurer American Automobile Insurance Company, A Fireman's Fund Company Rated 2008* A: XV (Excellent) by A.M. Best. **The information obtained from A.M. Best dated 11/13/07 is not in any way CalSurance's warranty or guaranty of the financial stability of the insurer in question, and that the information is current only as of the date of the publication. Claims Administration Brown & Brown of California, Inc. dba Lancer Claims Service Named Insured Agents/Brokers of Infinity Insurance who have paid the premium and whose names are on file with the insurer. Independent Contractors are also covered for the business they place through the Named Insured. Optional coverage is available for an additional premium to include Registered Representatives, who are also Agents/Brokers of Infinity Insurance and employed by the Named Insured, for the purpose of selling Mutual Funds, Annuities and Variable Products. Limits of Liability $1,000,000/$1,000,000 or $2,000,000/$2,000,000 or $2,000,000/$5,000,000 or $5,000,000/$5,000,000 Important Note: Each enrolled agency/brokerage is provided their own Limits of Liability just as if they had purchased a stand alone policy. This program also has no policy aggregate Limits of Liability. Defense Costs In Addition to the Limits of Liability Deductibles Various options Applies to Damages & Defense A reduced deductible benefit is available to the Agents of Infinity. If you have not made an E&O claim within the last 5 years of continuous Insurance Agent s and Brokers Professional Liability Insurance, the deductible will be reduced by 50% for the first claim made and reported during the current policy period arising out of Professional Services involving Infinity products. Territory Worldwide; suit must be brought in U.S., its territories or possessions. Retroactive Date Date of first continuous claims made E&O coverage, or Retroactive Date on the immediately preceding E&O policy, whichever is earlier. Coverage Acts, errors or omissions arising out of the rendering or failure to render Professional Services. Extended Reporting Period Agents/Brokers terminated from Infinity for reasons other than for cause shall receive a 90 day Extended Reporting Period starting on the date of contract termination or until the expiration of the policy at no additional premium. In the event of cancellation or non-renewal of this policy by the Carrier: - Optional Three Year ERP for an additional premium charge. In the event of cancellation of this policy due to the Insured s merger or consolidation with or sale to another entity or the death or retirement of the Insured: Optional Three to Ten Year ERP may be purchased. Optional Extended Reporting Period Endorsements must be purchased within 60 days of the cancellation of this policy. Duty to Defend Yes, to those claims for which coverage applies, and including the Innocent Insured extension. Limited Insolvency Coverage Applicable to all admitted Property and Casualty Insurers with an A.M. Best Rating of B+ or higher and life/accident and health Insurers with an A.M. Best Rating of A- or better. Covered Professional Services (Applicable to coverage options chosen & purchased) Sale and /or Servicing of: Property/Casualty Insurance, Life Insurance, Accident & Health Insurance, Disability Insurance and Annuities Appraising real or personal property for the purpose of purchasing insurance Claims adjusting and claims administration, excluding Third Party Administration (TPA) Engineering and loss control services for the purpose of purchasing insurance and/or self-insurance analysis Insurance Consulting Notarizing Premium Financing Optional: Variable Products including Variable Annuities, Equity Indexed Annuities and Variable Life Insurance; Mutual Funds registered with the Securities and Exchange Commission; Employee Benefit Plans other than a Multiple Employer Welfare Arrangement, including but not limited to Group Plans, Group or Ordinary Pension or Profit Sharing Plans, Keogh Plans, 401(k) or 501 (b) Plans, or Retirement Annuities ($1,000,000 Sub-limit applies to all products within this bullet) This information is a summary of coverage provided. All statements contained herein are subject to all of the terms, conditions and exclusions of the actual policy. Copy of policy available by calling CalSurance Risk Purchasing Group: By applying for this insurance:, Agents are applying for membership in the Financial Sales Professionals Risk Purchasing Group, a group formed and operating pursuant to the Liability Risk Retention Act of 1986 (15 USC 3901 et seq.). There is no additional charge for membership. InfinityFlyers_CASelect_123008v5 Page 3 of 7

4 A AGENTS & BROKERS OF INFINITY CALIFORNIA ENROLLMENT AND ELECTION FORM Claims Made & Reported Errors and Omissions Insurance January 1, 2009 to January 1, 2010 Firm Name: Contact Name Infinity Agent/Broker No: Mailing Address: City/State/Zip: Phone #: Fax#: Requested Effective Date: LIMIT OPTIONS DEDUCTIBLE OPTIONS COVERAGE DESIRED $1,000,000 Each Claim / $1,000,000 Aggregate Each Firm $ 1,000 Basic Coverage $2,000,000 Each Claim / $2,000,000 Aggregate Each Firm $ 2,500 Level I* (Includes Basic Coverage & Variable Products) $2,000,000 Each Claim / $5,000,000 Aggregate Each Firm $ 5,000 Level II* (Includes Level I Coverage & Mutual Funds) $5,000,000 Each Claim / $5,000,000 Aggregate Each Firm $10,000 *For additional premium see Line 5 in Premium Calculation below. PREMIUM CALCULATION See Premium Calculation Instructions, Rates & Factors on Page 5 Firms who do not fit into the criteria as listed on page 4 DO NOT qualify for automatic enrollment and must complete a full application for underwriting review and approval. 1. # of Licensed Staff (First 5): X (Rate) $ = $ 2. # of Licensed Staff (Next 5): X (Rate) $ = $ 3. # of Unlicensed Staff (First 5): X (Rate) $ = $ 4. # of Unlicensed Staff (Greater than 5): X (Rate) $ = $ 5. + Optional Coverage (Level I or Level II ) = $ 6. Total of 1-5 = $ 7. X Deductible Factor = $ 8. X Claims Debit Factor = $ 9. X Mid-Term Enrollment Factor = $ Administrative Fee: $ $ Total Premium Due: = $ Enclosed is my check for the full annual premium, made payable to. Payment by ACH Installments: I would like to pay my premium (above) in four equal installments by pre-authorized debits from my checking account. I understand and authorize to process first installment upon receipt of Enrollment Form then again on March 1, 2009, May 1, 2009 and July 1, I understand that a $7.50 processing fee will be added to the premium on each installment. Please return enrollment form with attached Debit Pre-Authorization Form along with a voided check. Without a completed Authorization Agreement and Pre- Authorized Debit Form, this Enrollment Form WILL NOT be processed. If the total premium due is greater than $10,000 and you wish to finance your premium, please contact CalSurance at for finance terms WARRANTY STATEMENT - IMPORTANT - SIGNATURE REQUIRED!! I understand and agree to the following: I must be a currently contracted agent or broker with Infinity to be eligible for this program, otherwise, I will not be considered an insured under this policy, no claims made against me will be covered, and any premiums paid by me will be returned. Should my contract with Infinity terminate for any reason, coverage will cease as of my date of contract termination. This is a claims made and reported policy. I have no knowledge of any pending claim or incident that could give rise to a claim under the proposed policy, and if any such claim exists, or knowledge or information exists and any claim or action arises therefrom, it is excluded from coverage for which this enrollment form applies. A potential gap in coverage may occur if I elect an effective date that is not continuous with my prior expiration date, and may result in denial of a claim. Furthermore, by signing below, I certify that my firm is eligible for automatic enrollment in accordance with the Automatic Enrollment Criteria shown on Page 4 of this form and my firm does not fall within the Program Ineligibility guidelines, also listed on Page 4 of this form. Return to: (Agency/Brokerage Principal Signature) Payment by Check or ACH Mail Form and check to: P.O. Box 7048, Orange, CA (Today s Date) Payment by ACH Fax Form to: (800) Infinity_CA-Standard_APP_123008v4 Page 4 of 7

5 A AGENTS & BROKERS OF INFINITY CALIFORNIA ENROLLMENT AND ELECTION FORM Claims Made & Reported Errors and Omissions Insurance January 1, 2009 to January 1, 2010 CALIFORNIA STANDARD AUTOMATIC ENROLLMENT CRITERIA IN ORDER TO QUALIFY FOR AUTOMATIC ENROLLMENT UNDER THE CALIFORNIA INFINITY PROGRAM, THE CALIFORNIA FIRM APPLYING FOR COVERAGE MUST MEET THE FOLLOWING CRITERIA: Basic Coverage 1. No more than 10 licensed staff; 2. Firms who have been in business for 3 years or more; 3. No more than 2 claims/incidents and/or no more than $50,000 in total incurred claims (paid + reserves) in the past 5 years; 4. No merger or acquisition activity in the past 5 years; If electing Financial Products Coverage Variable Products/Mutual Funds (Level I or Level II - $1,000,000 Sublimit) 1. Your agency derives no more than 10% of revenues from the sale/servicing of Variable Life, Variable Annuities, Mutual Funds or any related financial planning activities; 2. Deferred Annuity sales to Seniors (age 65 and older) is less than 10% of the agency s total annuity sales. IF YOUR FIRM DOES NOT MEET THE ABOVE CRITERIA, YOU DO NOT QUALIFY FOR AUTOMATIC ENROLLMENT AND MUST COMPLETE AN APPLICATION TO BE CONSIDERED FOR COVERAGE UNDER THE PROGRAM. TO OBTAIN AN APPLICATION, PLEASE CONTACT CALSURANCE CUSTOMER SERVICE AT PROGRAM INELIGIBILITY THE FOLLOWING FIRMS ARE INELIGIBLE FOR COVERAGE UNDER THE INFINITY PROGRAM: Agent/Agencies who have ever been subject to a complaint, reprimand, or disciplinary or criminal action by federal, state or local authorities as a result of their professional service activities. Agent/Agencies whose business as licensed Managing General Agent or Surplus Lines Broker represents greater than 10% of total agency revenues. If you have any questions regarding eligibility, please contact CalSurance at InfinityEnrollmentForm011808v5 Page 5 of 7

6 AGENTS OF INFINITY INSURANCE CALIFORNIA STANDARD Premium Calculation Instructions, Rates and Factors ANNUAL PREMIUM Rate For Each Licensed Staff Rate For Each Unlicensed Staff Limits of Liability First 5 Next 5 First 5 Greater than 5 $1 Million Each Claim/$1 Million Each Brokerage $2,358 $1,888 $1,179 $ 944 $2 Million Each Claim/$2 Million Each Brokerage $3,011 $2,412 $1,506 $1,206 $2 Million Each Claim/$5 Million Each Brokerage $3,247 $2,603 $1,624 $1,302 $5 Million Each Claim/$5 Million Each Brokerage $3,798 $3,042 $1,899 $1,521 Premium Calculation: Firms matching the following criteria are NOT eligible to self-rate and must complete a long form application: Basic Coverage 1. Firms with more than 10 licensed staff; 2. Firms who have been in business for less than 3 years; 3. Firms with more than 2 claims/incidents and/or more than $50,000 total incurred claims (paid + reserves) in the past 5 years; 4. Firms with any merger or acquisition activity over the past 5 years If electing Financial Products Coverage: Variable Products/Mutual Funds (Level 1 or Level II - $1,000,000 Sublimit): 1. Firms who derive more than 10% of revenues from the sale/servicing of Variable Life, Variable Annuities, Mutual Funds, or any related financial planning activities; 2. Deferred Annuity sales to Seniors (age 65 and older) is greater than 10% of the agency s total annuity sales. 1. Multiply the number of licensed staff (First 5) working in your firm by the rate from the premium table above. 2. Multiply the number of licensed staff (Next 5) working in your firm by the rate from the premium table above. 3. Multiply the number of unlicensed staff (First 5) working in your firm by the rate from the premium table above. 4. Multiply the number of unlicensed staff (Greater than 5) working in your firm by the rate from the premium table above. 5. If coverage is desired for the sale of variable products and/or mutual funds, add the appropriate additional premium as follows: Variable Products-Level I: $80 Mutual Funds and Variable Products-Level II: $ Add the licensed staff premium, the unlicensed staff premium, and optional (Level I or Level II) coverage premium. 7. Multiply the total of line 6. above by the deductible factor of your choice from the table below. Deductible Factor Deductible Factor $1, $ 5, $2, $10, Multiply the total of line 7. above by the appropriate Debit Modification for Claims Activity from the table below (loss payment, expense payment or loss reserves). Claims Activity Claims Debit Modification 0 Claims Multiply premium by Claims Multiply premium by If you are a mid-term enrollee, multiply the total of 8. (above) by the mid-term enrollment factor from the table below to calculate the total premium. If your Effective Date Is In This Month Multiply Your Premium By This Factor If your Effective Date Is In This Month Multiply Your Premium By This Factor January July February August March September April October May November June December Add the Administrative Fee of $ This is your Total Premium. CaliforniaInfinityPremiumCalcCalifornia12308v7 Page 6 of 7

7 Errors and Omissions Insurance Authorization Agreement for Pre-Authorized Debits AGENTS AND BROKERS OF INFINITY INSURANCE SEE ENROLLMENT INSTRUCTIONS FOR PREMIUM AMOUNT. I (we) hereby authorize CalSurance, hereinafter called COMPANY, to initiate electronic debit entries or effect a change by any other commercially accepted method, to my (our) checking account indicated below at the financial institution named below, hereinafter called Depository and to debit the same to such account. This authority is to remain in full force and effect until COMPANY and Depository have each received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and Depository a reasonable opportunity to act on it, but no less than three (3) business days before the next scheduled date. I (we) agree that if premiums are not paid on the dates specified below, or in the event the withdrawals are dishonored, coverage shall terminate upon ten (10) days Notice of Cancellation. Once cancelled, the agent will be eligible for reinstatement of coverage ONE time only within 10 days of the effective date of cancellation by paying appropriate premium in addition to a declined/non-sufficient fund fee of $ Annual premium will be divided into 4 (four) equal installments. Payments will be processed as follows: First installment will be taken upon receipt of Enrollment Form then again on, March 1, 2009, May 1, 2009 and July 1, I understand that a $7.50 processing charge will be added to each installment. In the event the coverage effective date is later than the installment dates shown above, the premium will be divided equally among the remaining installments. Name of Financial Institution: Address or Branch: City: State: Zip: Transit / ABA Number: Account Number: This authority is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and Financial Institution a reasonable opportunity to act on it, but no less than three (3) days before scheduled installment date. Name: Signature: Date: Signature: Date: (If account requires two signatures) Please attach a voided check, or photocopy thereof applicable to the above account in this space (enrollment will not be processed without it). January Infinity_ca_ACH_12208v3 Brown & Brown of California, Inc. dba Cal Surance Associates California Insurance License 0B02587 Page 7 of 7