At my direction, Abbey USA Inc. is authorized to place my coverages in the
domestic market and in the surplus lines market. As required by the State
Statute, I have agreed this placement in the surplus lines market and I have
been advised about all the differences between the admitted market and the
surplus lines market. I further understand the policy forms, conditions,
premiums, and deductibles used by surplus lines insurers may be different from
those found in policies used by authorized insurers. I have been advised to
carefully read the entire policy. There is no liability on the part of, and I
have no cause of action against, my agent for placing coverage in the surplus
lines market.
