CONSENT FOR ELECTRONIC SIGNATURES AND ELECTRONIC RECEIPT AND DELIVERY OF INSURANCE COVERAGE

Thank you for considering the purchase of insurance coverage (the “Insurance Coverage”) through Millennial Specialty Insurance, LLC and the various insurance companies that provide such Insurance Coverage (collectively, the “Company” or “us”). Please review the information below regarding your agreement and consent for us to deliver the insurance application for your purchase of Insurance Coverage, the insurance policy issued to you (the “Policy”) and any other documents, correspondences, disclosures or other related notices (the “Consent”) by electronic means.

YOUR CONSENT TO USE YOUR ELECTRONIC SIGNATURE: By signing this form, you agree (if necessary for your Insurance Coverage) to electronically to receive, sign and deliver to the Company an insurance application in the format designated by the Company (including all online instructions and applications provided to you electronically) for your purchase of Insurance Coverage (the “Insurance Application”), that your electronic signature thereon shall be your legally binding signature and that you agree to all the terms of this Consent for Electronic Signatures and Electronic Receipt and Delivery of Insurance Coverage. For certain Insurance Coverages, you may be asked to provide your consent via opt-in check box after being provided and reading this document. You further agree that your electronic signature or opt-in on any Insurance Document (as defined below) shall be your legally binding signature and agreement.

YOUR CONSENT TO ELECTRONIC DELIVERY OF INSURANCE APPLICATION, INSURANCE COVERAGE AND RELATED DOCUMENTS: By agreeing to this form, you agree to receive, in electronic form, from the Company, (1) any Insurance Applications, including all related required disclosures that we must deliver in writing to you as part of your Insurance Application; (2) your evidence of Insurance Coverage, including but not limited to the Policy, any certificate evidencing Insurance Coverage or any other binder or related document; and (3) any other documents, correspondences or notices, whether or not required to be provided to you under applicable law (along with the Insurance Application and the Policy, the “Insurance Documents”) which the Company may deliver to you in writing which, in each case, you agree shall constitute delivery of any such Insurance Document to you in writing when delivered to you electronically and, to the extent permissible under applicable law, you agree that electronic delivery shall satisfy any legal requirement to physically deliver any particular Insurance Document to you. You further agree that delivery to you of any Insurance Document by electronic means shall include, but is not limited to, e-mail attachments to your e-mail address, an e-mail to your e-mail address containing a hyperlink to a secure website containing such Insurance Document, or the posting of an Insurance Document on a secure website without any personally identifiable information about you.

When an Insurance Document is delivered to you via e-mail to your e-mail address you have provided to us alerting you that an electronic message is waiting for you at your electronic mailbox (which you may access by the hyperlink provided in our e-mail to you), you will promptly access the e-mail and the hyperlink therein to read each such message. If applicable law requires us to provide particular information to you in writing, we may provide that information to you by alerting you by e-mail that the information is waiting for you at your electronic mailbox, which will constitute our delivery of that information in writing to you. You are considered to have received delivery of information from us when we send notice to you at your e-mail address alerting you that the information has been delivered to you at your electronic mailbox.

HARDWARE AND SOFTWARE REQUIREMENTS. In order to use electronic signatures and to access, view, and retain any Insurance Documents:

• You must have a computer, mobile device, or other electronic device with internet access and
• A secure internet browser with 128-bit encryption;
• A current version of a program that accurately reads and displays “PDF” files, such as Adobe® Acrobat Reader® version; and
• A valid e-mail address and software to access that email account.

To print and save your Insurance Documents in electronic form using your computer, you will need:

• A printer (to print paper copies); and
• A hard drive or other device with sufficient electronic storage capacity (to download and save electronic copies).

To print and save your Insurance Documents in electronic form using your mobile or other electronic device, you will need:

• A printer capable of printing the screen shots on your mobile or electronic device (to print paper copies); and
• An electronic device capable of taking a screenshot that can be printed (to save electronic copies).

OBTAINING PAPER COPIES: You may contact us as set forth below to obtain paper copies from us of the Insurance Documents at no charge to you.

HOW TO CONTACT US AND/OR OPT-OUT: Your consent to receive Insurance Documents electronically is voluntary and you may opt-out at any time. If you wish to update your information required for the Insurance Documents or the electronic mail address where we send you the Insurance Documents; to withdraw your consent to use your electronic signature and receive delivery of the Insurance Documents in electronic form; or to request paper copies of them, please e-mail us at contactus@msimga.com and provide your full name, postal mailing address, telephone number and Policy number. You may also contact us at

Millennial Specialty Insurance LLC
PO Box 210788
Bedford, TX 76095

844-788-0873

AGREEMENT AND CONSENT: By opting into and agreeing to this Consent, I confirm, agree and consent that I:

• am the person whose name appears on the Insurance Application, the Policy and/or any Insurance Document which may be presented to me for my electronic signature and able to read this electronic Consent and print it on paper or electronically save it for my future access;
• have the technological ability to receive, open, read, print and retain the Insurance Application, the Policy and/or any Insurance Document in the forms in which they will be delivered to me based on the above-stated computer hardware and software requirements;
• will electronically receive delivery of and sign the Insurance Application, the Policy and/or any other Insurance Documents which may be presented to me for my electronic signature, opt-in, consent and be legally bound by my electronic signature thereon;
• will electronically receive delivery of evidence of my Insurance Coverage (including but not limited to my Policy) and all other Insurance Documents in electronic form; and
• agree to all the above terms and conditions of this Consent.

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