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PROOF OF INSURANCE (2023) CLOSEDNafi arurl 8pecWty Irowa= Company (a stack inwrance coven rg) 1s�(b L Don croft Bedford, Toxw 7W21 (80 877.4567 MASTER POLICY NO.: CEM 14 - 72 - DECLARATIONS ARBIERATORS, HEARING OFFICERS AND MEDIATORS PROFESSIONAL LIABILITY INSURANCE issued to the National l ti n of SalariedProfenionals Purchasmg Group, Inc. and SPECIFIED MEMBERS BVIDBNCE OF IMURANCE Namedq and Address RICIARID R. TMMAN . LIMITS OF LIABILITY: I. A Professional Liability - A.L Professional Liability and Personal Injury Coo e loch Claim $10O,Ci00.00' uctn wle -00 � 00 00 each claim Retroactive Date: NONE A3.' Social Enginwring Fraud Liability Each Claim WAW-00 Aggregate 125,000.00 Deductible $4000.00 each claim Retroactive Date: NONE Producer Name and Address Co cwa fate Equity Markets, Inc. 11 "W Court Lake Zurich, IL 60047 efense Cxnt coverage Each Claim wwpw w t twwN Deductible sw t tit ww each claim Retroactive Date: tr Overall ll Aggre, gate Limit'of Liability for Insuring Agreement I* A. P'ro�f"+essiom' l; Liability Aggregate: $600,000.00 UCER KULCHIN ROSS INS SVCS LLC 04C841 06 /AMERCURY 18757 BURBANK BLVD STE 320 INSURANCE COMPANY TARZANA, CA 91356 AUTOMOBILE POLICY DECLARATIONS TELEPHONE:(818) 996-0900 IMPORTANT COVERAGE EXCLUSION IL4 Y ;1V k � aIT Y 1T �) A CIO A�tl ��'SAA B 11� 1(�( C�3 �kT 1�01" �1 �0 TO I*1r�Sl(tlT1� 0401 06 120169474 w p r r ;t ri BIND NIN6URE rdDf 9f11S1S P�11 I f 0RLATER )L tl aYh1 IYw 1)YY� 9YII�uw+xYjrI�4 I)Itl pN(aY ��13�„wl�k�il .._w.,..».�,.��.Anr� �..M . �I4wYtl i�eYl ��p�►"� x�,at dt�LaYL':I�r.'tIN:I�yBr,all?�I Nit �I S7YSAYYN��i �Yr way a "(iarwa _— w w 1haa�i' ±wYm Yi h'*raw' 01,6ik*ik)% 144 k.� .. .. RICHARD R TERZIAN slr%N trRl4a ro11i)a,4,YuY::. . __. _....._ _. ......._...... ......_ tr �n.� }a9a Ar hsilirez� IRr a bdr�e:�t l ViY a mixsY ti d�riia ': DRIVERS..�.».m....:... .M...,,.�..,..........,...,. .,....,.....,...,,....,.......,.,.....«....,..».......,.,...�.»..,.................. RICHARD R TERZIAN NG.....�.......�......................................................._ ..................................................._.�... ........ RNG 265 BRON OOD AVE ADD LOS ANGELES, CA 90049 ;,._ .i .1..„ 1 2019 MERCEDES GLC 300 UTL 4X2 4D N 01 /2019 2 2019 MERCEDES E300 SED 4DR N 08/2019 CAR CP=Ri [d1 kr #;p�Y � 6'd.PY„ a4Y111YT1 YkY; YN�"YI�'N�.�'v , _� _ S dp'&ffit &wYYY kwS.dwS &btiw".9YYA6 YFldkl k $Ylb" "L1 " P w ti�t�, wY r a � 1 .t w Ylbw YI . 1.. ,LA MERCEDES.1,��; _.w;.,�� d.ti,��w�:��wa��.,:,r�� ;��..:� ,.,.:�..�.w� _��.��,.�, ."�.�.�.:: .W,.,W,�.�� ..,...w�� ..��,��w:.� ,�,.�.d,.a BENZ FINANCIAL PO BOX 685 ROANOKE TXW 76262 y 2 LA MERCEDES BENZ FINANCIAL PO BOX 685 ROANOKE TX 76262 2 Al CITY OF CHINO HILLS C/O EXIGIS INS COMPLIANCE SERVICES MURRIETA CA 92564 ._..._ �. _Coverage applies only if premium charge is listed below. Coverage/Limits are subject to all policy terms. °4.1M4TSF E?....._m... _.._ _ ::u 1'CI)YF5m .....__. _.... ��GY,` E ......� � ._,.w,.. BODILY INJURY LIABILITY $250,000 EACH PERSON $ 500,000 EACH ACCIDENT CART CAR2 CAR --- ITEMS INSURED AND AMOUNTS OF ........... ........ 230 293 INSURANCE FOR EACH ITEM ARE STATED PROPERTY DAMAGE LIABILITY $1 00,000 EACH ACCIDENT 235 274 HEREIN, ITEMS INSURED ARE SUBJECT TO $250,000 EACH PERSON $ 500,000 EACH ACCIDENT 134 206 TREDEDUCTIBLE BODILY INJURY LIABILITY,..,.. _.. ran r a iau0,77-7 UNINSURED MOTORISTS $ MAXIMUM PROPERTY DAMAGE LIABILITY ,SOWSION DEDUCTIBLE WAIVE 6 6 MEDICAL EXPENSE $5,000 4 5 LEASEILOAN GAP COVERAGE CAR CAR CAR REPAIR OR REPLACEMENT CAR CAR CAR COST COVERAGE COMPREHENSIVE......."""" ...... ..�DEDucnBLE CAR1 $1 ,000 CAR2 $1 ,000 CAR $ 11. 19i�1 .., C'AUFOR'NGA"A'SMEN1"8 . _.........,..,......�r.:_....�.�........__._...:.:.. COLLISION DEDUCTIBLE CAR1 $1 ,000 CAR2 $1,000 CAR $ 279 534 ! CA FRAUD FEE ROADSIDE SISTA AS �.......m,._ _..._._........._._.................�.....�..�..._..........._. _ NCE OGC CAR1 $75 CAR2 $75 CAR CIGA FEE............_... FOR TOWINGER SVICES OCCURREYCE 4 4 RENTAL CAR BENEFIT $50 PER DAY 30 DAYS 37 37 INTERVENOR FEE I :.,;. I IN1EQ�P$ �4fi IfA.6$1 .i. , ....... 1_ 940 ..W137S.__••___............................................................. TOTAL PREMIUM 2,318.00 IMPORTANT INFORMATION *For Non -Towing Services, Limit of Liability is $75 per Occurrence. Maximum 5 Occurrences in total for Towing and Non -Towing services per policy period. EFFECTIVE 12/03/2022 This amended policy declarations page replaces all declarations with the same or prior effective date. Reason(s) Amended ADD A.I.(S) If there is a lapse, coverage will not be provided during the lapse period. This change has resulted in no additional premium. Any outstanding amount is due as previously billed. If you have any questions, please contact your agent or broker at the phone number provided above. Thank you for placing your business with Mercury Insurance Company. MAILED TO: RICHARD R TERZIAN 265 BRONWOOD AVE ...................... N18EF1 0401 06 120189474 LOS ANGELES, CA 90049 12/30/2022 ....WW_...W..,....... .._ ................................... INSURED COPY Umbrella Schedule Policy No: MP00076805-02 Covered Persons: Richard Terzian Effective Date: 9/1.6/2022 Expiration Date: 9/16/2023 Personal Umbrella Personal Property Following are the locations declared In your application covered under a Personal Liability or Homeowners policy. Personal Residences, Primary Insurance Company & Rentals or Vacant Land Limits of Liability (in thousands' e SAFECO $500 Personal Drivers Following are the drivers declared in your application and are the only drivers who live in your household and/or regularly drive your vehicles. Personal Automobiles Following are personal vehicles listed in this,policy and covered under a personal auto policy.. Personal Automobiles Primary Insurance Company & Limit of Liability (in thousands) 2019 MERCEDES GLC300 MERCURY $250/500/100 2019 Mercedes E300 MERCURY $250/500/100 Personal Uninsured/Underinsured Motorist Following are policies covering uninsured motorist listed In this policy and covered under a personal auto policy. Primary insurance Company & Limit of, Liability ('in thousands) MERCURY $250/500 Unlicensed Vehicles, JetSkis & Watercraft Following are unlicensed vehicles, jet skis and watercraft listed in this policy and covered under a liability policy." Description Primary Insurance Company & F71-imit of Liability (in thousands) NOT COVERED Losses arising out of a property, auto, unlicensed vehicle or watercraft that is acquired or leased during the policy period are covered by this policy N they are covered by your primary insurance listed above or another replacement insurance company A.M. Best rated B+ (V11) or higher. MDUP 1001 (05A9) Umbrella Schedule Order ID: L87574INVID:1825837 Doc*:1 Issue Date:9A42022 01 Markel Insurance Company ORM Personal and Business Owner's Umbrella Declarations Insured Copy Named Insured: Broker: Richard Ter27an Kulchin Ross Insurance Services, LLC. 18757 Burbank Boulevard +contact: Mark WriIkin Phone: 818-996-0900 Policy No: MP00076805-02 Policy Period: 9/16/2022 To 9/16/2023 (12: 01 AM standard time at the address of the Insured.) Coverage A: Bodily Injury, Personal Injury, Advertising Injury and Property Damage Liability Coverage Limits of Liability for Each Loss: $5,000,000 * Policy Total Limit: Not applicable * The Policy Total Limit shown in this policy's Declarations for Coverage A is the most we will pay for all losses arising out of buslness operations and/or business property during each policy period. Coverage B: Excess Uninsured and Underinsured Motorists Bodily Injury Coverage Limits of Liability for Each Loss: $1,000,000 Policy Total Limit: $1,000,000 Self Insured Retention: None ($0) Charges Policy Premium: $1,864 Total Policy Premium: $1,864 Attached to and forming a part of Form: MUP M]IL 10001 (03/) 000 (06/10) MDUP 1000 (05/19) Endorsements Attached to this Policy at Time of Issue: MIL 1 14 ( 9/17) ) MIL 1214 (09/17) MUP 1302 (1020) MPIL 1073-CA (05/14) MPUP 1004-CA (05/19) State and Privacy Notices: MPUP 1005-CA(01 (05/19) MPIL 1007 Ol/20) MPIL 1083 (04/15) MPIL 1136 (10/20) Administered By: PersonalUmbrella.com Insurance Services, Inc. P. 0. Box 8586 Emeryville, CA 94662 (800)564-1799 Authorized Representatives: John K. Clark w MDUP 1000 (05/19) Umbrella Declaration (Page 1 of 1) Order ID: L87574INVID:1825837 Doc#:1 Issue Date:9A4/2022