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<br />01/01/1999 04:59 <br /> <br />7145415512 <br /> <br />COASTAL MEDIATIOt~ <br /> <br />PAGE 02 <br /> <br />~ <br />.PRCFBSSDW. LIABILITY JNSUR.AICB <br />..... to tilt <br />NAl'llWAL AS:!llCIATQ ~ SAlAR.JHD ~ PURCHA$DiI) ~ <br /> <br />END ~ 912160 <br />PREVIOUS# INITIAL <br />AU1H.# CP05CT7770 <br /> <br />Nm:a.d Anursd: <br />ILAR&\RA BCHAN I:IIA WASTAL M8DL\.l1tNsmtVlCBS <br />Cautal M.cIiatian Senru. <br />3OS6 Madeira A~ <br />C~bt. Mea CA 92626 <br /> <br />I!\IJIEH:B Of INStlRANl:::S .ntlftd wI:h c.rtaiII <br />~ATLLOYI,l'S,~ <br />PARTIC1PATI~ 1IBRBCJtI: HIOI5 <br /> <br />MJSCEl.LANBOUS B&O ProC..mw. Liability lmun.Dce <br />LIMITS OF LIABn.ITY: <br /> <br />.Eacll claim: <br />~~. <br />Diaudible <br />Retroactive Date: <br /> <br />Sl,lD),<IXlOO <br />$l.lD),(Q)JJ() <br />Sl.anoo IIIeh claim <br />NONE <br /> <br />PREMIUM Ollclu<liag ..o:IIllIn;mts): <br /> <br />$683.00 <br /> <br />Purchaai.Dg Choap tax: foe CA @ 35i <br /> <br />Dl"9 <br /> <br />TOTAL UDYD'S PREMIUM ODl:lndiDt T~: <br /> <br />S7(1149 <br /> <br />Speaa.l Cooditiou: <br />See Attacbed Schedule c4 Penna and. EndcnmantlI <br /> <br />Not.ict of CJaim Ie Swvio. d. Su.it: <br />Lord, ~ ~ Brook <br />130 South LaS&1l6 Street <br />Chicago n... 60603 <br /> <br />WOI'ding - MJ.....tt.'htOUJ PrdNlimal Lia.bility ATR <br />PERIOD OF INSURANCB: <br />From....y 1. '1tI1T 12:01 a.m. to War :J. D1112:Ol LID. <br />In ~ r1l tilt additieM1 pmniulll paUj IlIIIl. in ~ ~ UIe I.......... .. tbe ~ att'lldled hIreCo, t1lo abow ~ <br />membIc ;. 11II ANuM l.lMtr 1be ~ r1l1~ '"-' to tbt ~ AaoddJlIIl rL smri.c1 Pmf..um1l ~. Omljl. fa or <br />~q IlIinoI. by Undenni.. at lJoyd's:, Lmdm (mt inawpcnted) tor the ~ tL ~ and IlmitJ tIlliabOfty IPICIfItd atwM. All <br />Qtb..- --. awtitiml&, IDllIllduricn of.r. ~.. ~ <br />This 0IrtifM& nut u.. ~ 0IrtIficat. II a tne ClCIp)' rL ... adpal daGIImIet ~ <br /> <br />All otMr tmu,. ~ limita ud ...,h....... remain 1'_"'Dpd. <br />Attu:bIId to aDd tormiag pert at Cer1:if'ute No.: Nt 9lJX) - 06 UNlERWRlTERS AT LLOYD"S, LONDON <br /> <br />0I.t.d: April 24, 'NJ7 <br /> <br />~ Bq~1J't Marbta,!no. <br />db. ~ Marbta ~ ./'tpDq, <br />IDe. { <br />By ~7:P~ <br /> <br />f'1lM."i41 (po(}) ~ <br /> <br />~ <br /> <br />l'ILB CDII"J" <br /> <br />