PROOF OF INSURANCE (2019) CLOSED TRANSACTION NO.:NIA
VERIFICATION OF INSURANCE
Endorsement#857054
We, the undersigned insurance brokers, hereby certify that the following described insurance is in force at this date of
which--100—percent is insured with UNDEkWRITFRS AT LLOYD'S, LONDON
NAMEANDADDRE SS-OE-ASSURED
RICHARD R. TERZIAN
315 West Arden Suite 28
Glendale,CA 91203
ITPEA)EINSURANCE
ARBITRATORS,BEARING OFFICERS AND MEDIATORS PROFESSIONAL LIABILITY INSURANCE
LOCA11ONSAMAIEEWRSC LIEDULES
#1- Illinois Amendatory Lll 14-1 B #7-Nuclear Incident Exclusion Clause NMA 1256
#2-Service of'.Suit Clause LMA 5020 #8-Sanction Limitation and Exclusion Clause LMA 3100
#3-Applicable Law(U.S.A.)LMA 5021 #9-Data Security Breach LII 14-1 E
#4-Several Liability Notice LSW'1001
#5-Small Additional or Return Premiums Clause NMA U68
#6-Radioactive Contamination Exclusion Clause NMA 1477
UMI"R.AMOUNISME-COVYWAGE
Coverage A-Professional Liability and Personal Injury Coverage
Each claim: $100,000-00
Aggregate- $300,000.00
Coverage 8-Defense Cost Coverage
Each claim: $100,000,00
Aggregate: $300,000.00
Aggregate Limit of LiabiRY
Maximum insurance available for Coverages A and B combined: $600,000.00
Deductible-each claim including Cost of Defense: $1,000-00
Retroactive Date: NONE
POLKOLPHRIOD
January 1,201812:01 a.m.to January 1,2019 12.01 a.m.
This document is furnished to you as a matter of information only. The issuance of this document does not eke the
person ortion to whom it is issued an additional assured, nor does it modify in any manner the contract of
ce
insuran =the Assured and the Insurers. Any amendment, change or extension of such contract can only be
effected by specific Endorsement attached thereto.
Should the above mentioned contract of insurance be cancelled, Iss a i ned or changed during the above named policy period
in such manner as to affect this document, we, the undersigned, w!A endeavor to give written notice to the holder of this
document, but failure to give such notice shall impose no obligation of any land upon the undersigned or upon the
Insurers.
Print Date:November 28,2017 Complete ult Markets I'm
!7 #
dba Compt ui y Markets Insurarme Agnicy,I (CASL#OEW4077)
Lib*467 BY
Lawrence T.P.Molloy