Multi-Buyer Select Risk Policy (MBSR) Exclusions Worksheet

• Legal Form Number: EIB 18-01
• Issuer: Export-Import Bank of the United States
• Subject Matter: Insurance
• Section: Export-Import Bank of the United States

OMB No. 3048-0053

Expires 04/30/2025

MULTI-BUYER SELECT RISK POLICY (MBSR)

EXCLUSIONS WORKSHEET

Instructions:

Select and list the sales you wish to exclude. Add additional pages, if needed.

"Non-Standard" Exclusions must be EXIM authorized, and are available only for multibuyer policies with deductibles.

The Multi-Buyer Select Risk EXIM Policy Portfolio should represent at least 50% of the exporter’s Total Eligible Export

Credit Sales in U.S. dollars, excluding standard exclusions. Eligible Export Credit Sales are sales that comply with EXIM

programs and policies.

Please refer to the 2nd page of this form for guidance on calculating the Multi-Buyer Select Risk EXIM Policy Portfolio.

All endorsed exclusions are locked-in for the policy period.

Premiums must be paid on all "Reportable Transactions" as required by the insurance policy, except for the endorsed exclusions.

Sign the worksheet certification on the 2nd page of this form.

STANDARD EXCLUSIONS

Unconfirmed Irrevocable Letters of Credit

Payments at Sight (SDDP or CAD)

Sales to Subsidiaries and Affiliates

Sales to Canada

Any Invoice of $10,000 or less

None requested

NON-STANDARD EXCLUSIONS

Instructions: Please complete the information for each desired exclusion category. Any combination of categories is permitted.

A. Sales to Top Corporates (Companies with revenues > $100,000,000):

Buyer Name

City/Country

Total Annual Credit Sales

Payment Terms

B. Sales to Prime Customers (Companies that paid you promptly, < 60 days slow, fo r three consecutive years):

Buyer Name

City/Country

Total Annual Credit Sales

Payment Terms

C. Sales to the following Country (ies) are to be excluded:

Country

Total Annual Credit Sales

EIB 18-01 3/2018