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TRANSACTION NO.:N /A <br />VERIFICATION OF INSURANCE <br />Endorsement # 852178 <br />We, the undersigned insurance brokers, hereby certify that the €'ollowing ddscrilied i$susa�nce is in force at this date of <br />which 100 percent is insured with UNDERWRITERS AT LLOYD'S, LONDON <br />N MF Ar�uFC¢ O CSiIRFiI <br />BARBARA ECHAN <br />3056 Madeira Avenue �_ �O O �— Q �/ O <br />Costa Mesa, CA 92626 <br />TYPE OF INIS'i7R ANCI? <br />ARBITRATORS AND MEDIATORS PROFESSIONAL LIABILITY INSURANCE <br />n'ATi ©NS OTfffi2 S<'F� 7i FS - <br />Service fee $25.00 <br />#1 - Several Liability Notice LSW 1001 <br />#2 -Small Additional and Return Premiums Clause NMA 1168 <br />#3 - Radioactive Contar*+;*+ation Exclusion Clause NMA 1477 <br />#4 - Nuclear Incident Exclusion Clause NMA 1256 <br />#5 - Retroactive Exclusion Clause NMA 1587 <br />#6 - Dispute Resolution Services Exclusion AIF 2641 <br />PFROV AS TO FORM <br />1�9: <br />f� 2i i i <br />Y O. HODG <br />City Attoesey <br />x1,000,000.00 per cla;m/i'I,000,QQQ�QQ aggregate including costs and expenses <br />$1,000.00 deductible each and every claim including costs and expenses <br />$490.00 premium plus Purchasing Group Tax for CA @ 356 $14.70 <br />Retroactive Date_ June 1, 2011 <br />POLICY PERIOD <br />June 1, 2011 12:01 a.m. to June 1, 2012 12.01 a.m. <br />The insured listed above has no claim record with our company. <br />This document is furnished to you as a matter of information only_ The issuance of this document does not make the <br />person or organization to whom it is issued an additional assured, nor does it modify in any manner the contract of <br />insurance between the Assured and the Insurers. Any amendment, change or extension of such contract can only be <br />effected by specific Endorsement attached thereto. <br />Should the above mentioned contract of insurance be cancelled, assigned or changed during the above named policy period <br />in such manner as to affect this document, we, the undersigned, will endeavor to give written notice to the holder of this <br />document, but failure to give such notice shall impose no obligation of any kind upon the undersigned or upon the <br />Insurers. <br />Print Date_ May 27, 2011 <br />Lib�16 <br />Complete Eq(Iuity Markets, Inc. <br />dba Complete Equity Mazketa Insurance Agency, Inc. (CASI_.#OD4407'n <br />/' .i � i i <br />