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i <br />518!08 <br />E.L.M. INSURANCE BROKERS, INC <br />1990 EAST GRAND AVE, SUITE 210 / EL SEGUNDO, CA 90245 <br />INSURED: Barbara Echan <br />3056 Maderia Ave <br />Costa Mesa, CA 92626 <br />BINDER # 36701.011 <br />- <br />lU- �r��_ODG <br />TEL (310) 322 -1301 <br />FAX (310) 322 -1302 <br />CA LIC 9 OD28706 <br />AGENT: E.L.M. Insurance Brokers Inc <br />1990 E Grand Ave suite 210 <br />El Segundo, CA 90245 <br />Page 1 of 2 <br />Binder is effective from 12:01 AM 05101108 to 12:01 AM 07127108 unless cancelled or replaced by the Policy. <br />Policy is effective from 12:01 AM 05/01/08 to 12:01 AM 05101109. <br />This is to certify that, in accordance with your instructions, we have bound coverage as follows: <br />COMPANY: Certain Underwriters at Lloyds, London POLICY NO: 0509- 00122403A <br />AM BEST: A, XV <br />COVERAGE: Miscellaneous Professional Liability <br />COVERED Alternative Dispute Resolution services for others for a fee. <br />SERVICES: <br />RETRO DATE: 5!1107 <br />LIMITS: $1,000,000 per claim limit <br />$1,000,000 aggregate limit <br />DEDUCTIBLE: $5,000 per claim <br />CONDITIONS: Defense expenses are INSIDE policy limits. <br />Deductibles apply to loss and claim expense. ,(ti <br />SUBJECT TO: Carrier's receipt of premium - <br />FORMS: BRP MPL policy form <br />Nuclear Incident Exclusion <br />Service of Suit Clause (U.S.A.) <br />Several Liability Notice <br />War and Civil War Exclusion <br />War and Terrorism Exclusion Endorsement <br />Radioactive Contamination Exclusion Clause Liability Direct <br />Notice of Cancellation - ADR <br />Asbestos Exclusion <br />Extended Reporting Period Endorsement 100% - 125% Bilateral <br />If you have not been previously provided with a copy of the policy form and endorsements, specimens <br />are enclosed or will be provided at your request. Please read them carefully. <br />PAYMENT Option 1 - Payment in full: PLUS any quoted and fees are due upon receipt of our invoice. Save <br />TERMS: postage and overnight charges! PAY BY FAX with ELM - see attached form. <br />Option 2 - Financing: 25% down PLUS any quoted and fees are due upon receipt of our invoice. You <br />can use your own finance company (copy of the finance agreement is required at binding), or we can <br />provide you with an excellent financing quote with same -day draft authority through IBEX Financial <br />Services. Please advise if you are interested. <br />The following must be received if you use your own finance company: <br />1. A signed copy of your finance agreement listing ELM Insurance Brokers, Inc. as the Wholesaler - <br />