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DocuSign Envelope ID: 72574FBA-38BB-482F-A711-18C4CFEC2EDF <br /> Berkley Insurance Company <br /> Item 7. Prior and Pending Litigation Dates: <br /> 1. Directors, Officers and Corporate Liability Insurance: <br /> A. Insuring Agreements I.A.and I. B.: June 5,2010 <br /> B. Insuring Agreement 1. C.: June 5,2010 <br /> C. Outside Entity Coverage: June 5,2010 <br /> 2. Employment Practices Liability Insurance: June 5,2010 <br /> 3. Fiduciary Liability insurance: Not Applicable <br /> Item 8, Extended Reporting Period: <br /> Option 1: 12 months for 100.00 percent of the"full annual premium" <br /> Item 9. Forms and Endorsements attached: <br /> Policy Form: CT 32400(05-13); EPL 34400(05-13); MIL 36400 (05-13) <br /> 265(01-14) POLICYHOLDER DISCLOSURE <br /> BEL-NC-PAE (05-13) North Carolina Policy Amendatory Endorsement <br /> BEL-NC-PFA(05-13) North Carolina Proposal Form Addendum <br /> CT 200901 (05-13) Section 11.Severability of Exclusions <br /> CT 308901 (05-13) Section Ill. H,Addition of Listed Insured Entity <br /> CT 605102(05-13) Section VI. E.Modified Settlement Clause with Reduction in Deductible <br /> EPL 301901 (05-13) Section III.A. Claim Includes Illegal Alien Investigative Proceedings with Sub-Limit <br /> EPL 308911 (05-13) Section 111. H. Third Party Wrongful Act Endorsement <br /> EPL 3089,21 (05-13) Section Ill. H.Wage and Hour Wrongful Act with Costs of Defense Sub-Limit <br /> EPL 308951 (05-13) Section III. H.Wrongful Act Includes Social Media with Sub-Limit <br /> ML 204011 (05-13) Section 11. D. 1.Additional Excess Aggregate Limit of Liability Dedicated for Insured Persons <br /> ML 301901 (05-13) Section Ill.A. Claim Includes Extradition Coverage <br /> ML 301912(05-13) Section Ill.A. Claim Includes Formal Investigations with Deductible <br /> ML 301916(05-13) Section III.A.Claim Includes Investigation Costs for Shareholder Derivative Investigations <br /> Item 10. Notice to the Insurer as provided in sections VII.A.and VII. B. of the Common Policy Terms and Conditions Section of this <br /> Policy shall be sent to: <br /> Monitor Liability Managers, Claims Department <br /> Address: 2850 West Golf Road, Suite 800, Rolling Meadows, IL 60008-4039 <br /> Fax: (847)806-4017 <br /> Email: newclaim@monitorliability.com <br /> All other notices required to be given to the Insurer under this Policy shall be sent to: <br /> Monitor Liability Managers <br /> Address: 2850 West Golf Road, Suite 800, Rolling Meadows, IL 60008-4039 <br /> Fax: (847)806-6282 <br /> These Declarations along with the Common Policy Terms and Conditions Section, all Coverage Sections purchased as part of this <br /> Policy, and the Proposal shall constitute the contract between the Insureds and the Insurer, <br /> Authorized' Representative: Date Issued: May 22, 2014 <br /> DEC 32401 (05-13) 1287292 Raleigh Pathology Laboratory Associates, PA Page 2 of 2 <br />