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Insurance Group <br />ARCH INSURANCE COMPANY <br />A Missouri Corporation <br />ADMINISTRATIVE OFFICE HOME OFFICE <br />One Liberty Plaza 3100 Broadway, Suite 511 <br />53rd Floor Kansas City, MO 64111 <br />New York, NY 10006 <br />TO 800-817-3252 <br />LAWYERS PROFESSIONAL LIABILITY INSURANCE POLICY <br />THIS IS A CLAIMS -MADE AND REPORTED POLICY. PLEASE REVIEW YOUR POLICY <br />CAREFULLY. THE POLICY IS LIMITED TO LIABILITY FOR ONLY THOSE CLAIMS THAT <br />ARE FIRST MADE AGAINST THE INSURED AND REPORTED TO THE COMPANY DURING <br />THE POLICY PERIOD UNLESS AND TO THE EXTENT THAT AN EXTENDED REPORTING <br />PERIOD OPTION APPLIES. <br />Policy Number: 111 ?1,0709909 <br />Item 1 Named Insured and Address <br />Dmuld It. ilaxrtnr..APLC <br />235 Calstpa Dri+e <br />;Ailwrtoai CA 94427 <br />Item 3. Policy Period From <br />91!C2012 <br />Item 4 Limit Liability <br />Renewal of: I I ITt.aR 91198 <br />Item 2 Producer Name <br />3iams Affinity - We>t Dcs Moines. a wmce of Scahun k Smith. <br />f irsurancc prug'am 'Nanapement <br />PO Box 9277 <br />Ocs Wines, IA 50',1* -9277 <br />To 12:01 A.M. Standard Time at the address <br />91"201, of the Named Insured as stated herein. <br />Each Claim <br />$ t.0D0,U0U Aggregate <br />a. Claims cs}xnses arr indutk.d uithni the `imit, l.iabiliq <br />Item 5. Deductible <br />$ I0.txxt Per Claim <br />The deductihle amount slxcified abriw aoplics u, Ixtifl damages and claim cxiwnncs_ <br />Item 6. Premium <br />$ 6.824.00 Amount <br />Item 7. Forms Attached at Issue <br />05 TH. W2 05 06 04 Policy Fom <br />00 LPL 0174 04 0412 Data iircaeh Esix _xa Fn.lwvucnl <br />00 NIL 0065 DO (W7 0EAC <br />No. of Lawyers I <br />PI�°"—z'Ft+�=v'bHb SW%i'"^+"��a'Z.�S^npr T�emrv!'ro�'�Cc!'e�.xae.5tl:�J.rt:4(....sicer a.]eCrS.actr-o,K''n Y.l& ?£SikX9S5 ay55mt'-'ffd0 <br />t@Ci£y�xfyy4;vf5 fiN�'hdt °d9 CaY"=S m'u SC.J`,`n8^y/d£„aE'{.q£�9fffi•'.'R'n65n YM'=7ziY..i.M kx:Cmtim,�a S't�'C!•rg44yRFW z:r:ar_y�t 'rvS c3a`� <br />Do Not Write Remarks Countersigned At Issue Date <br />In This Box <br />05 LPLD0090 00 12 03 <br />Authorized Representative <br />APPROVED AS TOOytFORM� <br />LISA E. STORCK <br />Assistant City Attorney 1 /2_� <br />v. I'; 3012 <br />20t2 <br />Countersign Date <br />Page 1 of 1 <br />