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EXECUTIVE RISK INDEMNITY INC. <br />5/30/06 - A PSYCHOLOGISTS PROFESSIONAL LIABILITY POLICY <br />THIS IS A CLAIMS MADE POLICY - PLEASE READ CAREFULLY <br />*** RENEWAL *** <br />NOTICE: A LOWER LIMIT OF LIABILITY APPLIES TO JUDGEMENTS OR SETTLEMENTS WHEN THERE ARE ALLEGATIONS <br />OF SEXUAL MISCONDUCT (SEE THE SPECIAL PROVISION "SEXUAL MISCONDUCT" IN THE POLICY). <br />POLICY NO: 008-1741807 <br />ITEM I. (a) NAME AND ADDRESS OF INSURED: <br />ITEM 3. <br />ITEM 4. <br />ITEM 6. <br />ITEM 7. <br />SUSAN SAXE-CLIFFORD,PH.D <br />A PROFESSIONAL CORP. <br />16530 VENTURA BLVD. <br />SUITE 203 <br />ENCINO, CA 91436 <br />ACCOUNT NO: CA-SUSA165-0 <br />ITEM 1. (b) ADDITIONAL NAMED INSUREDS: <br />SUAN SAXE-CLIFFORD, <br />A- aGb7-o 4 o <br />A—aoo3-a-q7 <br />0427263B <br />114:N97 <br />TYPE OFORG: PROFESSIONAL CORPORATION <br />01/313-/07 <br />POLICY PERIOD: FROM: 03/01/06 TO: 03/01/07 <br />12:01A.M. STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATED HEREIN: <br />LIMITS OF LIABILITY: (a) $ <br />SCHEDULE: <br />(b) $ <br />1,000,000 EACH WRONGFUL ACT OR SERIES OF CONTINUOUS, REPEATED <br />OR INTERRELATED WRONGFUL ACTS OR OCCURRENCE <br />75,000 DEFENSE <br />(c) $ 3,000,000 AGGREGATE <br />CLASSIFICATION <br />NUMBER <br />RATE <br />ANNUAL PREMIUM <br />1ST PSYCHOLOGIST <br />1 <br />978.00 <br />978.00 <br />INDEPENDENT CONTRACTORS <br />4 <br />14.00 <br />56.00 <br />DEFENSE LIMIT <br />65.00 <br />ADDITIONAL INSUREDS <br />9 <br />250.00 <br />RETROACTIVE DATE: 03/01/04 TOTAL PREMIUM: <br />1,349.00 <br />1\V ! L:1VVL <br />ADDITIONAL PREMIUM (if exercised):$ 2,361.00 NO DISCOUNT INCLUDED. <br />ITEM 8. POLICY FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY <br />C22129 (7/95 ED.) C22128 C22092 <br />Y <br />THIS IS NOT A BILL. PREMIUM HAS BEEN PAID. Aui5i6RIZED COMPANY REPRE NTATIVE <br />APA22(10/95) AmericaRPmtcss anal Agency' 95 Broadway, Amityville, NY 11701 <br />