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DocuSign Envelope ID: 72574FBA-38BB-482F-A711-18C4CFEC2EDF <br /> Medical Mutual" <br /> FROI I CT INC 0 0 R PRO 'SION Medical Professional Liability <br /> NON-ASSESSABLE CLAIMS MADE POLICY <br /> RENEWAL DECLARATIONS PACE POLICY NO: PG1 120,61 <br /> Name and Address of Insured Policy Period <br /> Raleigh Pathology Laboratory Associates PA <br /> PO Box 14045 Effective Date:August 15,2014; 12:01 A.M. <br /> Raleigh,NC 27620 Expiration Date:August 15,2015; 12:01 A.M. <br /> L <br /> Endorsements:PCO20INC(09/10),PCO10INC(09/10),PE6001NC(06/13),PCO50INC(02/13),PE310INC(06/08),PE390,INC <br /> (06/08),PE650INC(12/13) <br /> Retroactive <br /> Cal ggrega o t Ptatxltul <br /> Michael Howard Weinstein,"NID 07/01/2002 6,000,00,0/8,000,000 <br /> ,Ming Yin,MD 01/13/2014 6`000,000/8,000,000 <br /> TOTAL PREMIUM: <br /> _A�4/'ellz 11 Date: Junc._25, 2014 <br /> A4/ozed Representative <br /> MEDICAL MUTUAL INSURANCE COMPANY BRIDGEC <br /> PDO20 INC(02/12) OF NORTH CAROLINA PIN:440306519 <br />