Document:

EX-4.2

 Exhibit 4.2 
 [Form of Note] 
 (FACE OF NOTE) 

THIS SECURITY IS A GLOBAL SECURITY WITHIN THE MEANING OF THE INDENTURE HEREINAFTER REFERRED TO AND IS REGISTERED IN THE NAME OF A DEPOSITORY OR A NOMINEE
OF A DEPOSITORY. UNLESS AND UNTIL IT IS EXCHANGED IN WHOLE OR IN PART FOR SECURITIES IN DEFINITIVE FORM IN ACCORDANCE WITH THE PROVISIONS OF THE INDENTURE AND THE TERMS OF THE SECURITIES, THIS GLOBAL SECURITY MAY NOT BE TRANSFERRED EXCEPT AS A WHOLE
BY THE DEPOSITORY TO A NOMINEE OF THE DEPOSITORY OR BY A NOMINEE OF THE DEPOSITORY TO THE DEPOSITORY OR ANOTHER NOMINEE OF THE DEPOSITORY OR BY THE DEPOSITORY OR ANY SUCH NOMINEE TO A SUCCESSOR DEPOSITORY OR A NOMINEE OF SUCH SUCCESSOR DEPOSITORY.

 AT&T INC. 
 3.550% Global Notes due 2032 
  

			
	No. [•]	  	ISIN NO. [•]

 AT&T Inc., a corporation duly organized and existing under the laws of the State of Delaware (herein
called “AT&T”, which term includes any successor Person under the Indenture hereinafter referred to), for value received, hereby promises to pay to The Bank of New York (Nominees) Limited, or registered assigns, the principal sum of
euro appearing on the attached Schedule of Increases and Decreases on December 17, 2032 (the “Maturity Date”), and to pay interest on said principal sum from December 17, 2012 or from the most recent Interest Payment Date to
which interest has been paid or duly provided for, annually in arrears on December 17 in each year, commencing on December 17, 2013 (each an “Interest Payment Date”) and on the Maturity Date, at the interest rate of
3.550% per annum, until the principal hereof is paid or made available for payment. The interest so payable, and punctually paid or duly provided for, on any Interest Payment Date will, as provided in such Indenture, be paid to the Person in
whose name this Note (or one or more Predecessor Notes) is registered at the close of business on the Regular Record Date for such interest, which shall be the close of business on December 1 (the “Regular Record Date”) next preceding
such Interest Payment Date. Any such interest not so punctually paid or duly provided for will forthwith cease to be payable to the Holder on such Regular Record Date and may either be paid to the Person in whose name this Note (or one or more
Predecessor Notes) is registered at the close of business on a Special Record Date for the payment of such Defaulted Interest to be fixed by the Trustee, notice whereof shall be given to Holders of Notes not less than 15 days prior to such Special
Record Date, or be paid at any time in any other lawful manner not inconsistent with the requirements of any securities exchange on which the Notes may be listed, and upon such notice as may be required by such exchange, all as more fully provided
in said Indenture. 

 Any money that AT&T deposits with the Trustee or any Paying Agent for the payment of
principal or any interest on this Note that remains unclaimed for two years after the date upon which the principal and interest are due and payable, will be repaid to AT&T upon AT&T’s request unless otherwise required by mandatory
provisions of any applicable unclaimed property law. After that time, unless otherwise required by mandatory provisions of any unclaimed property law, the Holder of this Note will be able to seek any payment to which such Holder may be entitled to
collect only from AT&T. 
 If the Notes are issued in definitive form, payment of the principal and interest on this Note
due at the Maturity Date or upon redemption will be made at the Maturity Date or upon redemption, as the case may be, upon presentation of this Note, in immediately available funds, at the office of The Bank of New York Mellon, the Paying and
Transfer Agent and Registrar for the Notes, currently located at 101 Barclay Street, New York, New York 10286. 
 Payment
of interest on this Note due on an Interest Payment Date, other than interest at maturity or upon redemption, may be paid by check mailed to the address of the Holder entitled thereto as such address shall appear in the Note register.
Notwithstanding the foregoing, (1) the Depository as Holder of the Notes or (2) a Holder of more than €5,000,000 in aggregate principal amount of Notes in definitive form is entitled to require the Paying Agent to make payments of
interest, other than interest due at maturity or upon redemption, by wire transfer of immediately available funds into an account maintained by the Holder, by sending appropriate wire transfer instructions as long as the Paying Agent receives the
instructions not less than ten days prior to the applicable Interest Payment Date. The principal and interest payable in such coin or currency of the member states of the European Monetary Union that have adopted or that adopt the single currency in
accordance with the treaty establishing the European Community, as amended by the Treaty on European Union as at the time of payment is legal tender for payment of public and private debts, on any of the Notes at maturity, or upon redemption, will
be paid by wire transfer of immediately available funds against presentation of a Note at the office of the Paying Agent. 

Reference is hereby made to the further provisions of this Note set forth on the reverse hereof, which further provisions shall for
all purposes have the same effect as if set forth at this place. 
 Unless the certificate of authentication hereon has been
executed by the Trustee referred to on the reverse hereof by manual signature, this Note shall not be entitled to any benefit under the Indenture or be valid or obligatory for any purpose. 

  
 2 

 IN WITNESS WHEREOF, AT&T INC. has caused this instrument to be signed in its corporate
name, manually or by facsimile, by its duly authorized officers and has caused its corporate seal to be imprinted hereon. 
  

							
	Dated: March 13, 2013	 		 	AT&T INC.
			
	[SEAL]	 		 	
				
		 		 	By:	 	 
		 		 		 	Name:
		 		 		 	Title:
				
		 		 	By:	 	 
		 		 		 	Name:
		 		 		 	Title:

 Trustee’s Certificate of Authentication 
 This is one of the 3.550% Global Notes due 2032 
 of the series designated herein referred to

 in the within-mentioned Indenture. 
  

			
	THE BANK OF NEW YORK MELLON, as Trustee	  	March 13, 2013

  

			
		
	By:	 	 
		 	Authorized Signatory

 REVERSE OF NOTE 

This Note is one of a duly authorized issue of debt securities of AT&T issued under and pursuant to an Indenture, dated as of
November 1, 1994, between AT&T and The Bank of New York Mellon, as Trustee (the “Trustee,” which term includes any successor Trustee under the Indenture), to which indenture and all indentures supplemental thereto (collectively,
the “Indenture”) reference is hereby made for a description of the rights, limitations of rights, obligations, duties and immunities thereunder of the Trustee, AT&T and the Holders of the Notes and of the terms upon which the Notes
are, and are to be, authenticated and delivered. The Notes will be issued in fully registered form only and in denominations of €100,000 and integral multiples of €1,000 in excess thereof. This Note is one of the series designated on the
face hereof initially limited in aggregate principal amount to €[•]. 
 The Indenture permits, with certain exceptions
as therein provided, the amendment thereof and the modification of the rights and obligations of AT&T and the rights of the Holders of the Notes under the Indenture at any time by AT&T and the Trustee with the consent of the Holders of a
majority in principal amount of the Notes at the time outstanding. The Indenture also contains provisions permitting the Holders of specified percentages in principal amount of the Notes at the time outstanding to waive compliance by AT&T with
certain provisions of the Indenture and certain past defaults under the Indenture and their consequences. Any such consent or waiver by the Holder of this Note shall be conclusive and binding upon such Holder and upon all future Holders of this Note
and of any Note issued upon the registration of transfer hereof or in exchange herefor or in lieu hereof, whether or not notation of such consent or waiver is made upon this Note. 

No reference herein to the Indenture and no provision of this Note or of the Indenture shall alter or impair the obligation of AT&T,
which is absolute and unconditional, to pay the principal of and interest on this Note at the times, place and rate, and in the coin or currency, herein prescribed. 
 Principal and interest payments in respect of the Notes are payable by AT&T in euro. Interest will be computed on the basis of the actual number of days in the period for which interest is being
calculated and the actual number of days from and including the last date on which interest was paid on the Notes (or December 17, 2012 if no interest has been paid on the Notes), to but excluding the next scheduled interest payment date. This
payment convention is referred to as ACTUAL/ACTUAL (ICMA) as defined in the rulebook of the International Capital Market Association. 

  
 4 

 Payment Without Withholding 

All payments in respect of the Notes by or on behalf of AT&T shall be made without withholding or deduction for, or on account of, any
present or future taxes, duties, assessments or governmental charges of whatever nature (“Taxes”) imposed, collected, withheld, assessed or levied by or on behalf of the Relevant Jurisdiction (as defined herein), unless the withholding or
deduction of the Taxes is required by law. In that event, AT&T will pay such additional amounts to a Holder who is a United States Alien (as defined herein) as may be necessary in order that the net amounts received by the Holder after the
withholding or deduction shall equal the respective amounts which would have been receivable in respect of the Notes in the absence of the withholding or deduction; except that no such additional amounts shall be payable in relation to any payment
in respect of any Note: 
  

	 	(a)	where such withholding or deduction would not have been so imposed but for: 

 (i) in the case of payment by AT&T, the existence of any present or former connection between the Holder (or between a fiduciary, settlor, shareholder, beneficiary or member of the Holder, if such
Holder is an estate, a trust, a corporation or a partnership) and the United States, including, without limitation, such Holder (or such fiduciary, settlor, shareholder, beneficiary or member) being or having been a citizen or resident or treated as
a resident thereof, or being or having been engaged in trade or business or presence therein, or having or having had a permanent establishment therein; 
 (ii) in the case of payment by AT&T, the present or former status of the Holder as a personal holding company, a foreign personal holding company, a passive foreign investment company, or a controlled
foreign corporation for United States federal income tax purposes or a corporation which accumulates earnings to avoid United States federal income tax; 
 (iii) in the case of payment by AT&T, the past or present or future status of the Holder as the actual or constructive owner of 10% or more of either the total combined voting power of all classes of
stock of AT&T entitled to vote if AT&T was treated as a corporation, or the capital or profits interest in AT&T, if AT&T is treated as a partnership for United States federal income tax purposes or as a bank receiving interest
described in Section 881(c) (3) (A) of the Internal Revenue Code of 1986, as amended; or 
 (iv) the failure by
the Holder to comply with any certification, identification or other reporting requirements concerning the nationality, residence, identity or connection with the United States (in the case of payment by AT&T) of such Holder, if compliance is
required by statute or by regulation as a precondition to exemption from such withholding or deduction; 

  
 5 

 (b) in the case of payment by AT&T to any United States Alien, if such person is a
fiduciary or partnership or other than the sole beneficial owner of any such payment, to the extent that a beneficiary or settlor with respect to such fiduciary, a member of such partnership or the beneficial owner would not have been entitled to
the additional amounts had such beneficiary, settlor, member or beneficial owner been the bearer of such Note. As used herein, “United States Alien” means any person who, for United States federal income tax purposes, is a foreign
corporation, a non-resident alien individual, a non-resident alien fiduciary of a foreign estate or trust, or a foreign partnership one or more of the members of which is, for United States federal income tax purposes, a foreign corporation, a
non-resident alien individual or a non-resident alien fiduciary of a foreign estate or trust; 
 (c) to the extent that the
withholding or deduction is as a result of the imposition of any gift, inheritance, estate, sales, transfer, personal property or any similar tax, assessment or other governmental charge; 

(d) to, or to a third party on behalf of, a Holder who is liable for the Taxes in respect of the Note by reason of his having any or some
present or former connection, including but not limited to fiscal residency, fiscal deemed residency and substantial interest shareholdings, with the Relevant Jurisdiction, other than the mere holding of the Note; 

(e) presented for payment more than 30 days after the Relevant Date except to the extent that a Holder would have been entitled to
additional amounts on presenting the relevant Note for payment on the last day of the period of 30 days assuming that day to have been an Interest Payment Date; 
 (f) any tax, assessment or other governmental charge required to be withheld by any paying agent from any payment of principal or of interest on any Note, if such payment can be made without withholding
by any other paying agent; 
 (g) any tax, assessment or governmental charge that is imposed or withheld solely because the
beneficial owner or any other person failed to comply with certification, identification or information reporting requirements concerning the nationality, residence, identity or connection with the United States of the holder or beneficial owner of
AT&T’s Notes, if compliance is required by statute, by regulation of the United States Treasury Department or by an applicable income tax treaty to which the United States is a party as a precondition to exemption from such tax, assessment
or other governmental charge; 
 (h) any tax, assessment or governmental charge that is imposed or withheld solely because of a
change in law, regulation, or administrative or judicial interpretation that becomes effective after the day on which the payment becomes due or is duly provided for, whichever occurs later; or 

(i) any combination of (a), (b), (c), (d), (e), (f), (g) or (h) immediately above. 

  
 6 

 Optional Redemption by AT&T 

Prior to September 17, 2032, the Notes will be redeemable, as a whole or in part, at AT&T’s option, at any time on at least
30 days’, but not more than 60 days’, prior notice mailed to the registered address of each Holder of the Notes. The redemption price will be equal to the greater of (1) 100% of the principal amount of the Notes to be redeemed or
(2) the sum of the present values of the Remaining Scheduled Payments (as defined below) discounted to the redemption date, on an annual basis (actual/actual (ICMA)), at a rate equal to the sum of the Treasury Rate (as defined below) and 25
basis points. In either case, accrued interest will be payable to the redemption date. On or after September 17, 2032, the Notes will be redeemable, as a whole or in part, at AT&T’s option, at any time on at least 30 days’, but
not more than 60 days’, prior notice mailed to the registered address of each Holder of the Notes at a redemption price equal to 100% of the principal amount of the Notes to be redeemed. Accrued interest will be payable to the redemption
date. 
 “Treasury Rate” means, with respect to any redemption date for the Notes, the price, expressed as a
percentage (rounded to three decimal places, 0.0005 being rounded upwards), at which the gross redemption yield (as calculated by the Trustee) on the Notes, if they were to be purchased at such price on the third dealing day prior to the date fixed
for redemption, would be equal to the gross redemption yield on such dealing day of the Reference Bond on the basis of the middle market price of the Reference Bond prevailing at 11:00 a.m. (London time) on such dealing day as determined by the
Trustee. 
 “Reference Bond” means, in relation to any Treasury Rate calculation, at the discretion of the Trustee, a
German government bond whose maturity is closest to the maturity of the Notes, or if the Trustee in its discretion considers that such similar bond is not in issue, such other European government bond as the Trustee may, with the advice of three
brokers of, and/or market makers in, European government bonds selected by the Trustee, determine to be appropriate for determining the Treasury Rate. 
 “Remaining Scheduled Payments” means, with respect to each Note to be redeemed, the remaining scheduled payments of principal of and interest on such Note that would be due after the related
redemption date but for such redemption. If such redemption date is not an interest payment date with respect to such Note, the amount of the next succeeding scheduled interest payment on such Note will be reduced by the amount of interest accrued
on such Note to such redemption date. 
 On and after the redemption date, interest will cease to accrue on Notes or any portion
of the Notes called for redemption, unless the Company defaults in the payment of the redemption price and accrued interest. On or before the redemption date, the Company will deposit with a paying agent or the Trustee money sufficient to pay the
redemption price of and accrued interest on the Notes to be redeemed on such date. If less than all of the Notes are to be redeemed, the Notes to be redeemed shall be selected by the Trustee by lot or by such other method as the Trustee shall deem
fair and appropriate. 

  
 7 

 Redemption for Taxation Reasons 

If (a) as a result of any change in, or amendment to, the laws or regulations of a Relevant Jurisdiction, or any change in the
official interpretation of the laws or regulations of a Relevant Jurisdiction, which change or amendment becomes effective after December 11, 2012, on the next Interest Payment Date AT&T would be required to pay additional amounts as
provided or referred to above under “Payment Without Withholding” and (b) the requirement cannot be avoided by AT&T’s taking reasonable measures available to it, AT&T may at its option, having given not less than 30 nor
more than 60 calendar days’ notice to the Holders (which notice shall be irrevocable), redeem all the Notes, but not some only, at any time at their principal amount together with interest accrued to, but excluding, the date of redemption
provided that no such notice of redemption shall be given earlier than 90 days prior to the earliest date on which AT&T would be obliged to pay such additional amounts were a payment in respect of the Notes then due. Prior to the publication of
any notice of redemption pursuant to this paragraph, AT&T shall deliver to the Trustee a certificate signed by two executive officers of AT&T stating that the requirement referred to in (a) above will apply on the next Interest Payment
Date and setting forth a statement of facts showing that the conditions precedent to the right of AT&T so to redeem have occurred cannot be avoided by AT&T taking reasonable measures available to it and an opinion of independent legal
advisers of recognized international standing to the effect that AT&T has or will become obliged to pay such additional amounts as a result of the change or amendment, in each case to be held by the Trustee and made available for viewing at the
offices of the Trustee on request by any Holder. 
 “Relevant Date” means the date on which the payment first becomes
due but, if the full amount of the money payable has not been received by the Trustee on or before the due date, it means the date which is seven days after the date on which, the full amount of the money having been so received, notice to that
effect shall have been duly given to the Holders by AT&T. 
 “Relevant Jurisdiction” means the State of Delaware
and the United States or any political subdivision or any authority thereof or therein having power to tax or any other jurisdiction or any political subdivision or any authority thereof or therein having power to tax to which AT&T becomes
subject in respect of payments made by it of principal and interest on the Notes. 
 Any reference in the terms of the Notes to
any amounts in respect of the Notes shall be deemed also to refer to any additional amounts which may be payable herein. 

Registrar and Paying Agent 
 AT&T shall maintain in the Borough of Manhattan, The City of New York, an office or agency where Notes may be surrendered for registration of transfer or exchange (“Registrar”) and an office
or agency where Notes may be presented for payment or for exchange (“Paying Agent”). AT&T has initially appointed the Trustee, The Bank of New York Mellon, as its Registrar and Paying Agent. AT&T may vary or terminate the
appointment of any of its paying or transfer agencies, and may appoint additional paying or transfer agencies. 

  
 8 

 Further Issues 

AT&T reserves the right from time to time, without notice to or the consent of the Holders of the Notes, to create and issue further
notes ranking equally and ratably with the Notes in all respects, or in all respects except for the payment of interest accruing prior to the issue date or except for the first payment of interest following the issue date of those further notes. Any
further notes will have the same terms as to status, redemption or otherwise as the Notes. Any further notes shall be issued pursuant to a resolution of the board of directors of AT&T, a supplement to the Indenture, or under an officers’
certificate pursuant to the Indenture. 
 Notes in Definitive Form 

If (1) an Event of Default has occurred with regard to the Notes represented by this Note and has not been cured or waived in
accordance with the Indenture, or (2) the Depository is at any time unwilling or unable to continue as depository and a successor depository is not appointed by AT&T within 90 days, AT&T may issue notes in definitive form in exchange
for this Note. In either instance, an owner of a beneficial interest in the Notes will be entitled to the physical delivery in definitive form in exchange for this Note, equal in principal amount to such beneficial interest and to have such Notes
registered in its name. 
 Notes so issued in definitive form will be issued as registered notes in minimum denominations of
€100,000 and integral multiples of €1,000, unless otherwise specified by AT&T. 
 Notes so issued in definitive
form may be transferred by presentation for registration to the Registrar at its New York office and must be duly endorsed by the Holder or the Holder’s attorney duly authorized in writing, or accompanied by a written instrument or instruments
of transfer in form satisfactory to AT&T or the Trustee duly executed by the Holder or his attorney duly authorized in writing. 
 AT&T may require payment of a sum sufficient to cover any tax or other governmental charge that may be imposed in connection with any exchange or registration of transfer of definitive Notes.

 Default 
 In case an Event of Default, as defined in the Indenture, shall have occurred and be continuing, the principal hereof may be declared, and upon such declaration shall become, due and payable, in the
manner, with the effect and subject to the conditions provided in the Indenture. 

  
 9 

 Miscellaneous 

For purposes of the Notes, the term “Business Day” means any day other than a Saturday or Sunday or a day on which banking
institutions in The City of New York or the City of London are authorized or required by law or executive order to close. The term “New York Business Day” means any day other than a Saturday or Sunday or a day on which banking institutions
in The City of New York are authorized or required by law or executive order to close. 
 No director, officer, employee or
stockholder, as such, of AT&T shall have any liability for any obligations of AT&T under this Note, the Indenture or for any claim based on, in respect of or by reason of such obligations or their creation. Each Holder by accepting this Note
waives and releases all such liability. The waiver and release are part of the consideration for the issue of this Note. 
 The
Notes are the unsecured and unsubordinated obligations of AT&T and will rank pari passu with all other evidences of indebtedness issued in accordance with the Indenture. 

Notices to Holders of the Notes will be published in authorized newspapers in The City of New York and in London. AT&T is deemed to
have given the notice on the date of each publication or, if published more than once, on the date of the first publication. 

Prior to due presentment of this Note for registration of transfer, AT&T, the Trustee and any agent of AT&T or the Trustee may
treat the Person in whose name this Note is registered as the owner hereof for all purposes, whether or not this Note be overdue, and neither AT&T, the Trustee nor any such agent shall be affected by notice to the contrary. 

All terms used in this Note which are defined in the Indenture shall have the meanings assigned to them in the Indenture. 

The Indenture and this Note shall be governed by and construed in accordance with the laws of the State of New York. 

  
 10 

 SCHEDULE OF INCREASES OR DECREASES 
 The initial principal amount of this Global Note is €[•]. The following increases or decreases in this Global Note have been made: 

 

									
	 Date of
 Exchange
	  	Amount of
decrease in
Principal
Amount of this
Global Note	  	Amount of
increase in
Principal
Amount of this
Global Note	  	Principal amount
of this Global
Note following
such decrease or
increase	  	Signature of
authorized
signatory of
Trustee or
Securities
Custodian

  
  

  
 11EX-10.1

 Exhibit 10.1 
 Dated this [date] 
 B E T W E E N : 

TOWER GROUP INTERNATIONAL, LTD. 
 and 
 [PARTY] 

 
  

INDEMNIFICATION AGREEMENT 
  

 
 Conyers
Dill & Pearman Limited 
 Barristers & Attorneys 

Hamilton, Bermuda 

 TABLE OF CONTENTS 

 

							
	 1
	 	 INTERPRETATION
	  	 	3	  
			
	 2
	 	 AGREEMENT TO SERVE
	  	 	5	  
			
	 3
	 	 INDEMNITY OF DIRECTOR/OFFICER
	  	 	5	  
			
	 4
	 	 INDEMNIFICATION FOR EXPENSE OF A WITNESS
	  	 	6	  
			
	 5
	 	 DETERMINATION OF ENTITLEMENT TO INDEMNIFICATION
	  	 	6	  
			
	 6
	 	 ADVANCEMENT OF EXPENSES
	  	 	7	  
			
	 7
	 	 REMEDIES OF INDEMNITEE IN CASES OF DETERMINATION NOT TO INDEMNIFY OR TO ADVANCE EXPENSES
	  	 	8	  
			
	 8
	 	 OTHER RIGHTS TO INDEMNIFICATION
	  	 	8	  
			
	 9
	 	 ATTORNEYS’ FEES AND OTHER EXPENSES TO ENFORCE AGREEMENT
	  	 	9	  
			
	 10
	 	 LIMITATION OF INDEMNIFICATION
	  	 	9	  
			
	 11
	 	 LIABILITY INSURANCE
	  	 	9	  
			
	 12
	 	 DURATION OF AGREEMENT
	  	 	9	  
			
	 13
	 	 NOTICE OF PROCEEDINGS BY INDEMNITEE
	  	 	10	  
			
	 14
	 	 MISCELLANEOUS
	  	 	10	  
			
	 15
	 	 NOTICES
	  	 	11	  
			
	 16
	 	 HEADINGS
	  	 	12	  
			
	 17
	 	 COUNTERPARTS
	  	 	12	  
			
	 18
	 	 GOVERNING LAW
	  	 	12	  

  
 1 

 INDEMNIFICATION AGREEMENT 
 THIS AGREEMENT is made the [DATE] 
 BETWEEN: 

Tower Group International, Ltd., a company incorporated under the laws of Bermuda with its registered office located at Clarendon House, 2 Church Street,
Hamilton 11, Bermuda (the “Company”); and 
 [NAME] of [ADDRESS] (the “Indemnitee”) 

WHEREAS the Indemnitee is a [director/officer] of the Company, 
 WHEREAS highly skilled and competent persons are becoming more reluctant to serve public companies as directors or officers unless they are provided with adequate protection through insurance and
indemnification against inordinate risks of claims and actions against them arising out of their service to and activities on behalf of such companies, 
 WHEREAS uncertainties relating to indemnification increase the difficulty of attracting and retaining such persons, 
 WHEREAS the Board has determined that an inability to attract and retain such persons is detrimental to the best interests of the Company and that the Company should act to assure such persons that there
will be increased certainty of such protection in the future, 
 WHEREAS, it is reasonable, prudent and necessary for the Company contractually
to obligate itself to indemnify the Indemnitee to the fullest extent permitted by Bermuda law so that the Indemnitee will serve or continue to serve the Company free from undue concern that the Indemnitee will not be so indemnified, 

WHEREAS, the Indemnitee is willing to serve, continue to serve and to take on additional service for or on behalf of the Company on the condition that
the Indemnitee be so indemnified, 

  
 2 

 IT IS HEREBY AGREED as follows: 

 

	1	INTERPRETATION 

  

	1.1	In this Agreement unless the context otherwise requires, the following words and expressions shall have the following meanings: 

 

			
	this “Agreement”	  	means this Indemnification Agreement;
		
	the “Board”	  	means the board of directors of the Company;
		
	“Business Day”	  	means any day other than a Saturday, Sunday or public holiday in Bermuda;
		
	the “Companies Act”	  	means the Companies Act 1981;
		
	“Corporate Status”	  	means the status of a person who is or was a director, officer, employee, agent, or fiduciary of the Company or any other Group Company, or is or was serving at the request of the
Company as a director, officer, employee, agent or fiduciary of any other company, corporation, partnership, limited liability company, joint venture, trust, employee benefit plan or other entity or enterprise;
		
	“the Court”	  	means the Supreme Court of Bermuda;
		
	“Disinterested Director”	  	means a director of the Company who is not or was not a party to a Proceeding in respect of which indemnification is sought by the Indemnitee;
		
	“Group Companies”	  	means the Company and each subsidiary of the Company (wherever incorporated or organized);

  
 3 

			
	“Independent Counsel”	  	means a law firm or a member of a law firm that neither is presently nor in the past five years has been retained to represent: (i) the Company or the Indemnitee in any matter
material to either such party, or (ii) any other party to the Proceeding giving rise to a claim for indemnification hereunder. Notwithstanding the foregoing, the term “Independent Counsel” shall not include any person who, under the
applicable standards of professional conduct then prevailing, would have a conflict of interest in representing either the Company or the Indemnitee in an action to determine the Indemnitee’s right to indemnification under this
Agreement;
		
	the “Parties”	  	means the parties to this Agreement collectively, and “Party” means any one of them; and
		
	“Proceeding”	  	means any action, suit, arbitration, alternate dispute resolution mechanism, investigation, administrative hearing or any other proceeding whether civil, criminal, administrative or
investigative and whether formal or informal;

  

	1.2	In this Agreement unless the context otherwise requires: 

  

	 	(a)	references to statutory provisions shall be construed as references to those provisions as amended or re-enacted or as their application is modified by other provisions
from time to time and shall include references to any provisions of which they are re-enactments (whether with or without modification); 

  

	 	(b)	references to clauses and schedules are references to clauses hereof and schedules hereto; references to sub-clauses or paragraphs are, unless otherwise stated,
references to sub-clauses of the clause or paragraphs of the schedule in which the reference appears; 

  
 4 

	 	(c)	references to the singular shall include the plural and vice versa and references to the masculine shall include the feminine and/or neuter and vice versa; and

  

	 	(d)	references to persons shall include companies, partnerships, associations and bodies of persons, whether incorporated or unincorporated. 

 

	2	AGREEMENT TO SERVE 

 The
Indemnitee agrees to continue to serve as a director/officer of the Company. This Agreement does not create or otherwise establish any right on the part of the Indemnitee to be and continue to be elected or appointed a director/officer of the
Company or any other Group Company and does not create an employment contract between the Company and the Indemnitee. 
  

	3	INDEMNITY OF DIRECTOR/OFFICER 

  

	3.1	Subject to clause 10, the Company shall indemnify the Indemnitee if the Indemnitee is a party or is threatened to be made a party to any threatened, pending or
completed Proceeding, including a Proceeding brought by or in the right of the Company, by reason of the fact that the Indemnitee is or was a director, officer, employee, agent, or fiduciary of the Company or is or was serving at the request of the
Company as a director, officer, employee, agent, or fiduciary of any other company, corporation, partnership, limited liability company, joint venture, trust, employee benefit plan or other entity or enterprise or by reason of anything done or not
done by the Indemnitee in any such capacity. Subject to clause 10, pursuant to this sub-clause 3.1 the Indemnitee shall be indemnified against expenses (including attorneys’ fees and disbursements), judgments, penalties, fines and amounts paid
in settlement actually and reasonably incurred by the Indemnitee in connection with such Proceeding (including, but not limited to, the investigation, defense, settlement or appeal thereof). 

 

	3.2	Notwithstanding any other provision of this Agreement other than clause 10, the Indemnitee shall be indemnified against all expenses (including attorneys’ fees and
disbursements) actually and reasonably incurred by the Indemnitee or on the Indemnitee’s behalf in defending any Proceedings referred to in clause 3.1 in which judgement is given in his favour, in which he is acquitted, or in respect of which
relief is granted to him by the Court under section 281 of the Companies Act. 

  

	3.3	 Subject to clause 10, the Company shall indemnify the Indemnitee for such portion of the expenses (including attorneys’ fees), witness fees,
damages, judgments, fines and amounts paid in settlement and any other amounts that the 

  
 5 

	 	
Indemnitee becomes legally obligated to pay in connection with any Proceeding referred to in clause 3.1 in respect of which the Indemnitee is entitled to indemnification hereunder, even if the
Indemnitee is not entitled to indemnification hereunder for the total amount thereof. 

  

	3.4	Without limiting the scope of the indemnity provided under any other provision of this Agreement, if the Indemnitee has reason to apprehend that any claim will or might
be made against him in respect of any negligence, default, breach of duty or breach of trust, he may apply to the Court for relief pursuant to section 281 of the Companies Act and, to the extent that the Court relieves him, either wholly or partly,
from his liability in accordance with section 281 of the Companies Act, the Indemnitee shall be indemnified against any liability incurred by him in defending any Proceedings in accordance with paragraph 98(2)(b) of the Companies Act.

  

	4	INDEMNIFICATION FOR EXPENSE OF A WITNESS 

 Subject to clause 10, to the extent that the Indemnitee is, by reason of the Indemnitee’s Corporate Status, a witness in any proceeding, the Indemnitee shall be indemnified by the Company against all
expenses actually and reasonably incurred by the Indemnitee or on the Indemnitee’s behalf in connection therewith. 
  

	5	DETERMINATION OF ENTITLEMENT TO INDEMNIFICATION 

  

	5.1	The Indemnitee shall request indemnification pursuant to this Agreement by notice in writing to the secretary of the Company. The secretary shall, promptly upon receipt
of the Indemnitee’s request for indemnification, advise in writing the Board or such other person or persons empowered to make the determination as provided in sub-clause 5.2 that the Indemnitee has made such request for indemnification.
Subject to clause 10, upon making such request for indemnification, the Indemnitee shall be presumed to be entitled to indemnification hereunder and the Company shall have the burden of proof in the making of any determination contrary to such
presumption. 

  

	5.2	Upon written request by the Indemnitee for indemnification pursuant to sub-clause 3.1, the entitlement of the Indemnitee to indemnification pursuant to the terms of
this Agreement shall be determined by the following person or persons who shall be empowered to make such determination: 

  

	 	(a)	the Board, by a majority vote of the Disinterested Directors; or 

  

	 	(b)	if such vote is not obtainable or, even if obtainable, if such Disinterested Directors so direct by majority vote, by Independent Counsel in a written opinion to the
Board, a copy of which shall be delivered to the Indemnitee; or 

  

	 	(c)	by a majority vote of the shareholders. 

  
 6 

	5.3	For purposes of sub-clause 5.2, Independent Counsel shall be selected by the Board and approved by the Indemnitee. Upon failure of the Board to so select such
Independent Counsel or upon failure of the Indemnitee to so approve, such Independent Counsel shall be selected by a single arbitrator pursuant to the rules of the American Arbitration Association. Such determination of entitlement to
indemnification shall be made not later than 60 days after receipt by the Company of a written request for indemnification. Such request shall include documentation or information which is necessary for such determination and which is reasonably
available to the Indemnitee. Subject to clause 10, any expenses (including attorneys’ fees) incurred by the Indemnitee in connection with the Indemnitee’s request for indemnification hereunder shall be borne by the Company irrespective of
the outcome of the determination of the Indemnitee’s entitlement to indemnification. If the person or persons making such determination shall determine that the Indemnitee is entitled to indemnification as to part (but not all) of the
application for indemnification, such persons may reasonably prorate such partial indemnification among such claims, issues or matters in respect of which indemnification is requested. 

 

	6	ADVANCEMENT OF EXPENSES 

All reasonable expenses incurred by the Indemnitee (including attorneys’ fees, retainers and advances of disbursements required of
the Indemnitee) shall be paid by the Company in advance of the final disposition of any Proceeding at the request of the Indemnitee as promptly as possible, and in any event within twenty days after the receipt by the Company of a statement or
statements from the Indemnitee requesting such advance or advances from time to time. The Indemnitee’s entitlement to such expenses shall include those incurred in connection with any Proceeding by the Indemnitee seeking an adjudication or
award in arbitration pursuant to this Agreement. Such statement or statements shall reasonably evidence the expenses incurred by the Indemnitee in connection therewith and shall include or be accompanied by an undertaking by or on behalf of the
Indemnitee to repay such amount if it is ultimately determined that the Indemnitee is not entitled to be otherwise. Subject to clause 10, the Company shall have the burden of proof in any determination under this clause 6. No amounts advances
hereunder shall be deemed an extension of credit by the Company to the Indemnitee. 

  
 7 

	7	REMEDIES OF INDEMNITEE IN CASES OF DETERMINATION NOT TO INDEMNIFY OR TO ADVANCE EXPENSES 

 

	7.1	In the event that: (a) a determination is made that the Indemnitee is not entitled to indemnification hereunder; (b) payment has not been timely made
following a determination of entitlement to indemnification pursuant to clause 5; or (c) expenses are not advanced pursuant to clause 6, the Indemnitee shall be entitled to apply to the Court or any other court of competent jurisdiction for a
determination of the Indemnitee’s entitlement to such indemnification or advance. 

  

	7.2	Alternatively to sub-clause 7.1, the Indemnitee, at the Indemnitee’s option, may seek an award in arbitration to be conducted by a single arbitrator pursuant to
the rules of the American Arbitration Association, such award to be made within sixty days following the filing of the demand for arbitration. The Company shall not oppose the Indemnitee’s right to seek any such adjudication or award in
arbitration or any other claim. 

  

	7.3	A judicial proceeding or arbitration pursuant to this clause 7 shall be made de novo and the Indemnitee shall not be prejudiced by reason of a determination otherwise
made hereunder (if so made) that the Indemnitee is not entitled to indemnification. Subject to clause 10 if a determination is made pursuant to the terms of clause 5 that the Indemnitee is entitled to indemnification, the Company shall be bound by
such determination and is precluded from asserting that such determination has not been made or that the procedure by which such determination was made is not valid, binding and enforceable. If the court or arbitrator shall determine that the
Indemnitee is entitled to any indemnification hereunder, the Company shall pay all reasonable expenses (including attorneys’ fees and disbursements) actually incurred by the Indemnitee in connection with such adjudication or award in
arbitration (including, but not limited to, any appellate proceedings). 

  

	8	OTHER RIGHTS TO INDEMNIFICATION 

 The indemnification and advancement of expenses (including attorneys’ fees) provided by this Agreement shall not be deemed exclusive of any other right to which the Indemnitee may now or in the
future be entitled under any provision of the Company’s bye-laws, any agreement, vote of shareholders, the Board or Disinterested Directors, provision of law, or otherwise; provided, however, that: (a) this Agreement supersedes any other
agreement that has been entered into by the Company with the Indemnitee which has as its principal purpose the indemnification of the Indemnitee and (b) where the Company may indemnify the Indemnitee pursuant to either this Agreement or the
bye-laws of the Company, the Company may indemnify the Indemnitee under either this 

  
 8 

 
Agreement or the bye-laws but the Indemnitee shall, in no case, be indemnified by the Company in respect of any expense, liability or cost of any type for which payment is or has been actually
made to the Indemnitee under any insurance policy, indemnity clause, bye-law or agreement, except in respect of any excess beyond such payment. 
  

	9	ATTORNEYS’ FEES AND OTHER EXPENSES TO ENFORCE AGREEMENT 

 In the event that the Indemnitee is subject to or intervenes in any Proceeding in which the validity or enforceability of this Agreement is at issue or seeks an adjudication or award in arbitration to
enforce the Indemnitee’s rights under, or to recover damages for breach of, this Agreement the Indemnitee, if the Indemnitee prevails in whole or in part in such action, shall be entitled to recover from the Company and shall be indemnified by
the Company against, any actual expenses for attorneys’ fees and disbursements reasonably incurred by the Indemnitee, provided that in bringing such action, the Indemnitee acted in good faith. 

 

	10	LIMITATION OF INDEMNIFICATION 

 Notwithstanding any other terms of this Agreement, nothing herein shall indemnify the Indemnitee against, or exempt the Indemnitee from, any matter prohibited by the Companies Act. 

 

	11	LIABILITY INSURANCE 

 To
the extent the Company maintains an insurance policy or policies directors’ and officers’ liability insurance, the Indemnitee shall be covered by such policy or policies, in accordance with its or their terms, to the maximum extent of the
coverage available for any Company director or officer. 
  

	12	DURATION OF AGREEMENT 

This Agreement shall apply with respect to the Indemnitee’s occupation of any of the position(s) described in sub-clause 3.1 of this
Agreement prior to the date of this Agreement and with respect to all periods of such service after the date of this Agreement, even though the Indemnitee may have ceased to occupy such position(s). 

  
 9 

	13	NOTICE OF PROCEEDINGS BY INDEMNITEE 

  

	13.1	The Indemnitee agrees promptly to notify the Company in writing upon being served with any summons, citation, subpoena, complaint, indictment, information or other
document relating to any Proceeding which may be subject to indemnification hereunder, provided, however, that the failure to so notify the Company will not relieve the Company from any liability it may have to the Indemnitee except to the extent
that such failure materially prejudices the Company’s ability to defend such claim. With respect to any such Proceeding as to which the Indemnitee notifies the Company of the commencement thereof: 

 

	 	(a)	the Company will be entitled to participate therein at its own expense; and 

 

	 	(b)	except as otherwise provided below, to the extent that it may wish, the Company jointly with any other indemnifying party similarly notified will be entitled to assume
the defense thereof, with counsel reasonably satisfactory to the Indemnitee. After notice from the Company to the Indemnitee of its election so to assume the defense thereof, the Company will not be liable to the Indemnitee under this Agreement for
any legal or other expenses subsequently incurred by the Indemnitee in connection with the defense thereof other than reasonable costs of investigation or as otherwise provided below. The Indemnitee shall have the right to employ the
Indemnitee’s own counsel in such Proceeding, but the fees and expenses of such counsel incurred after notice from the Company of its assumption of the defense thereof shall be at the expense of the Indemnitee and not subject to indemnification
hereunder unless (a) the employment of counsel by the Indemnitee has been authorized by the Company; (b) in the reasonable opinion of counsel to the Indemnitee there is or may be a conflict of interest between the Company and the
Indemnitee in the conduct of the defense of such Proceeding; or (c) the Company shall not in fact have employed counsel to assume the defense of such action, in each of which cases, subject to clause 10, the fees and expenses of counsel shall
be at the expense of the Company. 

  

	13.2	Neither the Company nor the Indemnitee shall settle any claim without the prior written consent of the other (which shall not be unreasonably withheld).

  

	14	MISCELLANEOUS 

  

	14.1	Notwithstanding the expiration or termination of this Agreement howsoever arising, such expiration or termination shall not operate to affect such of the provisions
hereof as are expressed or intended to remain in full force and effect. 

  
 10 

	14.2	If any of the clauses, conditions, covenants or restrictions of this Agreement or any deed or document emanating from it shall be found to be void but would be valid if
some part thereof were deleted or modified, then such clause, condition, covenant or restriction shall apply with such deletion or modification as may be necessary to make it valid and effective so as to give effect as nearly as possible to the
intent manifested by such clause, condition, covenant or restriction. 

  

	14.3	This Agreement shall be binding upon the Company and its successors and assigns (including any transferee of all or substantially all of its assets and any successor or
resulting company by merger, amalgamation or operation of law) and shall inure to the benefit of the Indemnitee and the Indemnitee’s spouse, assigns, heirs, estate, devises, executors, administrators or other legal representatives.

  

	14.4	This Agreement, together with any documents referred to herein, contains the whole agreement between the Parties in respect of the subject matter of this Agreement and
supersedes and replaces any prior indemnification arrangement between the Company and the Indemnitee, and any prior written or oral agreements, representations or understandings between them relating to such subject matter. The Parties confirm that
they have not entered into this Agreement on the basis of any representation that is not expressly incorporated in this Agreement. Without limiting the generality of the foregoing, neither party shall have any remedy in respect of any untrue
statement made to him upon which he may have relied in entering into this Agreement, and a Party’s only remedy is for breach of contract. However, nothing in this Agreement purports to exclude liability for any fraudulent statement or act.

  

	14.5	No provision in this Agreement may be amended unless such amendment is agreed to in writing, signed by the Indemnitee and by a duly authorised officer of the Company.
No waiver by either Party of any breach by the other Party of any condition or provision of this Agreement to be performed by such other Party shall be deemed a waiver of a similar or dissimilar condition or provision at the same or any prior or
subsequent time. Any waiver must be in writing and signed by the Indemnitee or a duly authorised officer of the Company, as the case may be. 

  

	15	NOTICES 

 Any notice
required to be given hereunder shall be in writing in the English language and shall be served by sending the same by prepaid recorded post, facsimile or by delivering the same by hand to the address of the Party or Parties in question as set out
below (or such other address as such Party or Parties shall notify the other Parties of in accordance with this clause). Any notice sent by post as provided in this clause shall be deemed to have been served five Business

  
 11 

 
Days after despatch and any notice sent by facsimile as provided in this clause shall be deemed to have been served at the time of despatch and in proving the service of the same it will be
sufficient to prove in the case of a letter that such letter was properly stamped, addressed and placed in the post; and in the case of a facsimile that such facsimile was duly despatched to a current facsimile number of the addressee. 

Name: 
 Address:

 Fax: 

Name: 
 Address:

 Fax: 
  

	16	HEADINGS 

 The headings in
this Agreement are inserted for convenience only and shall not affect the construction of this Agreement. 
  

	17	COUNTERPARTS 

 This
Agreement may be executed in any number of counterparts, each of which when executed shall be deemed an original but all such counterparts shall constitute one and the same instrument. Delivery of a counterpart signature page by facsimile
transmission or by e-mail transmission of an Adobe Portable Format file (or similar electronic record) shall be effective as delivery of an executed counterpart signature page. 

 

	18	GOVERNING LAW 

 The terms
and conditions of this Agreement and the rights of the parties hereunder shall be governed by and construed in all respects in accordance with the laws of the Islands of Bermuda. The parties to this Agreement hereby irrevocably agree that the courts
of Bermuda shall have non-exclusive jurisdiction in respect of any dispute, suit, action, arbitration or proceedings (“Agreement Proceedings”) which may arise out of or in connection with this Agreement and waive any objection to Agreement
Proceedings in the courts of Bermuda on the grounds of venue or on the basis that the Agreement Proceedings have been brought in an inconvenient forum. 

  
 12 

 AGREED by the Parties through their authorised signatories on the date first written above: 

For, and on behalf of Tower Group International, Ltd. For, and on behalf of [Name of Party] 

 

					
	  
	 		 	  

	Signature	 		 	Signature
			
	  
	 		 	  

	Print Name	 		 	Print Name
	[	 		 	[
			
	  
	 		 	  

	Date]	 		 	Date]

  
 13

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