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ENDORSEMENT NO.: 853228 TRANSACTION NO.: N/A <br />PREVIOUS ENDORSEMENT NO.: 716120 AUTHORIZATION NO.: (UMR) B1294CP103613 <br />CUSTOMER NO.: 10021992 <br />Endorsement to <br />Master Certificate No. CEM 14 -13 <br />DECLARATIONS <br />ARBITRATORS, HEARING OFFICERS AND MEDIATORS PROFESSIONAL LIABILITY INSURANCE <br />issued to the <br />NATIONAL ASSOCIATION OF SALARIED PROFESSIONALS PURCHASING GROUP, INC. <br />and SPECIFIED MEMBERS <br />EVIDENCE OF INSURANCE affected with certain <br />UNDERWRITERS AT LLOYD'S, LONDON <br />PARTICIPATION HEREON: 100% ..- - - - - -- <br />Specified BETSY BENTON <br />Member 2750 Artesia Boulevard #465 <br />Redondo Beach CA 90278 <br />LIMITS OF LIABILITY: <br />Coverage A - Professional Liability and Personal Injury Coverage <br />Each claim: $110001000,00 <br />Aggregate: $1,000,0)0,00 <br />Coverage B - Defense Cost Coverage <br />Each claim: $1,000,000.00 <br />Aggregate: $1,000,000,00 <br />Aggregate Limit of Liability <br />Maximum insurance available for Coverages A and B combined $2,000,000.00 <br />Deductible - each claim including Cost of Defense: $1,000.00 <br />Retroactive Date: NONE <br />PREMIUM (Including endorsements): $468.00 pp VE AS TO FORM <br />Purchasing Group Tax for CA @ 3% $14.04 <br />� I <br />R N .HODGE <br />TOTAL LLOYD'S PREMIUM (Including Texas): $482.04 ---ass <br />istant itv Atternev <br />PERIOD OF INSURANCE: <br />From January 1, 201412:01 a.m. to January 1, 201512:01 a.m., at the Specified Member's address, above. <br />Special Conditions: See attached Summary page <br />In consideration of the premium paid and in reliance upon the statements in the application attached hereto, the above specified member is an Assured under <br />the Master Certificate ( "Cartificate'9 issued to the National Association of Salaried Professionals Purchasing Group, Inc. of Illinois by Underwriters at <br />Lloyd's, London (not incorporated) for the Period of Insurance and Limits of Liability specified above. All other terms, conditions, and exclusions rs the of <br />Certificate are unchanged. <br />This certifies that the attached Cortificate is a true copy of the original document issued to the Association, which is hereby issued to the Specified Member. <br />Dated: December 16, 2013 <br />LII 14.1 Dec (01113) <br />medforms*g66 (PO) <br />FILE COPY <br />UNDERWRITERS AT LLOYD'S, LONDON <br />Complete Equity Markets, Inc. <br />dba Complete Equity Markets Insurance Agency, <br />Inc. (CASL#OD44077) <br />By <br />Lawrence T.P. Molloy <br />