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AUG 29,1011 12:36 ENBER S11TES 9492669191 pA t I <br />lxu+Avuarq mn <br />VY,NIYICAI ION U' INdUNANCQ <br />YndnrainuN N RS2JA1 <br />We the undenignel mnuaora hrngerq 6arehy ruldy flnl the follovm{ dattnhd mwnm'u is to fnraa al IFit <br />ilAu of "Si" IIYI Itpuil i�utNmul 06 pNI1h.NWNIIh,NSnI LLUYf1'S, LONDON <br />NAME, ANIt In1NPgrn;vunNlw NAM16, AN�,1p�RESS fIPyppEp <br />Mu. hmha lrry 11ila SIAPHQN H. SOLOMON <br />Earmns lnwrann 9171 Hendeuoo Way <br />311XpppacQwd $vile 2lB Villa Park, CA 92861 <br />Minwn Vmo, CA 92091 <br />1YPF OF ma <br />ARBITRATORS AND MEDIATORS PROPCISIONAL LIAQILIIY INSURANCE <br />IACAiIONS ANP107HFR�7¢1JN,P$ <br />Senne fee IS.W <br />Nl Srvrnl Ln6tlily Nouar LSW 1NI <br />N2Small Addiharul and Relurn Premiums Clam NMA 1168 ,,,�{'''������ <br />MJ Podimahre Conlamin�uan 6arluaon Claw NMA 1411 <br />P Nudeur Indent Padus�ion Claott NMA 12fd <br />kS � ArEdnlw Prmedm s Ertlmmn AIE 2040 <br />LIMIISOR AMOIMy$ OFCOVF� <br />}I,pMI,IXMIIq (Nrolmmgl,gX1,01q07 a+�nGala mdudm {wns and oapunwr <br />61,IXNIW dWuds0leeud and every rlaun maludmg oau and aayrmns <br />NOBW premium plw PuttMvng Group iaa lm CA n11;P {Ir IN <br />Rmtmdive Oau,WNG <br />LI PERI <br />luoa I, 2011 fb01 a.m.lo Iona I, dO21IDl a.m <br />the Imurud hiu�d nbma Sax im ¢laini ruvurJ •ith uus �nwpaoy. <br />1Eu tlaumem n Purnn6ad to yai of a maRrr al ndusniation only 1'lu ivnana n! Ihu duumenl duo iml <br />ma4r the Anon m xgoniulian to v6am n u muM an addl4onal ursurud, imr i6s II innJNy m any manner <br />the rwlnnl of imurvue hetreen IM Asmled and IMF hnurau Any smunJirrm, dian{e of adennon of moh <br />nuslrart ran only IM efforVd by spetdu Endonemonl auuhod IMrvla <br />Should the afore mmlarad mntmd of mmnn<e G ansrlWd, auignud �u uhnngnl dnrinp Ilu afore wrtrtd <br />pouy penotl m fuoh manner as to affrty Ihu duumenl,.u, thu nadcriignad, vdl endprorta {Iw vnAen <br />nulim In Ilia hnhlur of thn drcnmml, Eul fmlore to pirr mah naluu shall iinpmo n0 nnhgnlmn of any Ymd <br />upm Ihu imdortNnel m npnn the Imuress. <br />Compluw I!i mty Mndoh, Inr. <br />Prim lYlu iuly 22, 2011 dOsfrmpho �goiiy Nadol�lmunom 1pnry, Im. Nd448arNlmil <br />LC41 �p <br />