PROOF OF INSURANCE (2020) CLOSED TRANSACTION NO.:N/A
VERIFICATION OF INSURANCE
Endorsement # 858202
We, the undersigned insurance brokers, hereby certify that the following described insurance is in force at this date of
which �� percent is insured with UNDERW'R'ITERS AT.LLOYD'S, LONDON
NAME-AND-ADGRESS.Of-ASSURED
RICHARD R. TERZIAN
315 West Arden Avenue Suite 28
Glendale, CA 91203
T_" EE OF rN URA CE
ARBITRATORS, HEARING OFFICERS AND MEDIATORS PROFESSIONAL LIABILITY INSURANCE
LDCATICN: AND...O11*M, II Es
#1- Illinois Amendatory LII 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 1168
#6 -Radioactive Contamination Exclusion Clause NMA 1477
L1M:I'I S C1u�R AMO-THTS OF C1OVERA,GE
Coverage A- Professional Liability and Personal Injury Coverage
Each claim: $100,000.00
Aggregate: $300,000.00
Coverage B-Defense Cost Coverage
Each claim: $100,000.00
Aggregate: $300,000.00
Aggregate Limit of Liability
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
POLICY PERIOD
January 1,201912:01 a.m. to January 1, 202012:01 a.m.
This document is furnished to you as a matter of information only. The issuance of this document does not make the
person or organization to whom it is issued an additional assured, nor does it modify in any manner the contract of
insurance between 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, assigned or changed during the above named policy period
in such manner as to affect this document, we, the undersigned, will endeavor to give written notice to the holder of this
document, but failure 'to give such notice shall impose no obligation of any kind upon the undersigned or upon the
Insurers.
Print Date: November 14, 2018 Completeuity Markets, Inc.
dba Cs ar�plete1uity Markets Insurance Agency,In .(CASL#OD44077)
Lib*467
By
Lawrence T.P.Molloy