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<br />.. <br /> <br />I <br />t. <br /> <br />III <br /> <br />JEFFERSON PILOT <br />FINANCIAL <br /> <br />Jefferson Pilot Financial Insurance Company <br />8801 Indian Hills Drive, Omaha NE 68114-4066 <br />(402) 361-7300 A Stock Company <br /> <br />Group Policyholder: <br /> <br />Florida - Life Specimen <br /> <br />In Consideration of the Group Policyholder's application for this Policy and payment of all premiums when due, <br />Jefferson Pilot Financial Insurance Company agrees to make the payments provided in this Policy to the persons <br />entitled to them. <br /> <br />The fIrst premium for this Policy is due on its effective date, Subsequent premiums are due on June 1,2001, and on <br />the same day of each month after that. Policy anniversaries will be each May 1st; unless shown otherwise on the <br />Premium Rate Schedule inside. <br /> <br />The provisions and conditions set forth on the following pages are a part of this Policy, as fully as if recited <br />over the signatures below, <br /> <br />Jefferson Pilot Financial Insurance Company has executed this Policy at its Home Office in Omaha, <br />Nebraska. The issue date of this Policy is May 1, 2001. <br /> <br />~~ <br /> <br />Chief Executive Officer <br /> <br />~~ <br /> <br />Secretary <br /> <br />GROUP INSURANCE POLICY <br />No. XXXXXXXXXXXX <br />PROVIDING <br />LIFE INSURANCE <br />ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE <br />DEPENDENT LIFE INSURANCE <br /> <br />GL1101-TITLE PAGE <br /> <br />Exhibit "A" <br /> <br />95 <br />05/01/01 <br />