(a) For each insurance policy procured by an excess line broker pursuant to section 2118 of the Insurance Law and this Part, the excess line broker shall retain, for a period of no less than five years after policy expiration, copies of all affidavits required by section 27.5 of this Part and a complete and separate record showing:

1. (1) the exact amount of each kind of insurance procured;
2. (2) the gross premiums for each kind of insurance;
3. (3) the amount of premiums returned to the insured for each kind of insurance;
4. (4) the name of the unauthorized insurer or insurers that issued the policy and, in the case of a placement with Lloyd's, the names and the separate participation and proportionate premium of each such underwriter;
5. (5) the effective date of the policy;
6. (6) the material terms of the policy or a complete copy of any policy required by section 27.10(b) of this Part;
7. (7) the basis for premium tax allocation, if any;
8. (8) a copy of the notice required in section 27.15(e) of this Part;
9. (9) the cities and villages within this State in which the insured risks are located or resident; and
10. (10) in the case of fire insurance coverage, the name of the city, village, fire district or fire protection district in which the insured property is located.