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DocuSign Envelope ID: 1D03195F-09B6-4CDF-BCE2-75BE4FF7B2FF <br /> ......... ......... ......... ......... ............................................... .. ......... ......... ......... .... ...... <br /> :.. <br /> CERTIFICATE OF LIABILITY INSURANCE 02/02/2015 <br /> PRODUCER/AGENT i THIS CERTIFICATE;IS ISSUED AS A MATTFR OF INFORMATION ONI Y <br /> Dentist's Advantage AND CONFERS NO RIGHTS UPON TI I CERTIFICA'1 E I IOLDER. THIS <br /> 159 East County Line Road CFR'1'11-'ICATE DOES NOT AMEND,EXTEND OR AL l'E;R TI IE COVERAOF: <br /> I lulboro,PA 19040 AFFORDED RY TI W POLICIES E31:LOW. <br /> 1. <br /> INSURED INSURER A: National Union Fire Insurance Company of Pittsburgh,PA, <br /> Meng Monica Meng-Haggerty,DDS INSURER 13: <br /> 215 Bluefield Rd <br /> INSURER C: <br /> Chapel Hill,NC 27517 INSURER D: <br /> INSURER E: <br /> COVERAGES <br /> T!{£POLICIES OF INSURANCE LISTED BLLOW HAVE BEEN ISSUED 1'O TIIC INSURED NAMED ABOVE FOR T1117;POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br /> REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, <br /> THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALI.THE TERMS,FXCLUSIONS AND CONDfCIONS OF SUCH POLICIES, AGGREGATF <br /> L6MTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSRLTR TYPE OF INSURANCE POLICY FF ECF1VE POLICY EXPIRATION LIMITS <br /> NUAtDBR DATE(AINIIDDNY) DATC(SIN, <br /> (.ENERALLIADTLFTY FiACIIOCCURRFNCE! Not Included <br /> ❑COMMERCIAL GENERAL_LIAUIIATY TENANTS'LEGAL LIABILITY Not-Included <br /> ❑CI-MtS MADE❑OCCURRENCE MEDEXP(Any One pemnE Not Included <br /> PERSONAL&ADV INARY Not Included <br /> - GENERAL AGGREGATE Not Included <br /> PRODUCTS-COMPIOP AGO Not Included <br /> GE1N'L AGGREGATE LIMIT APPLIES PER: <br /> ❑POLICY ❑ PRO)ECT ❑LOC <br /> AUTOMOBILE LIABILITY CONSEIlNIi1)SINGLE LIMIT <br /> ❑ANY AUTO Ead�arcidrm <br /> BODILY INJURY <br /> ❑ALL OWNED AUTOS Any nne rfon NOF Included <br /> ❑SCHEDULEnAUTOS BODILY 1N1I1RY Not Included <br /> Per Rident <br /> ❑HIRED AUTOS cc <br /> ❑NON-OWNED AUTOS PROPERTY DAMAGE <br /> ❑ (Paa Mtrd) <br /> GARAGE LIABILITY AUTO ONLY-EACI I ACCED1iNr <br /> ❑ANY AUTO UA ACT. <br /> ❑ OTFIEK II IAN AUTO ONLY: <br /> AGO <br /> EXCESS LIABILITY EACH OCCURRENCE <br /> ❑ CLAIMS NUDE ❑OCCURRENCE AGGRI:GATE - <br /> ❑ DEDUCr1aLE <br /> ❑ REEINTION S I t 1 1 <br /> WORKER'S CONIMNSAT1ON AND <br /> 13 1YC STA71rI0RY ❑OTI IER <br /> EAIPLOYER'S LIABILITY <br /> E.L,EACH ACCIDIiNT <br /> E.L.DISEASE-EACH <br /> l <br /> END'LOYEE <br /> E.L.DISEASr.-POLICY LIMIT <br /> OTIIER <br /> A Mod,Malpractice DNU 089946381 041091205 04109120t6 Per Claim: 51,000,000 <br /> Retroactive Date: Aggregate, S3,000,006 <br /> DESCRIPTION OF OPERATI ONS4.00ATIONSNJIUICLE.SWCLUSIONS ADDED BY ENT)ORSELMENTISPECIAL PROVISIONS <br /> Insured Dentist: Metro Date: Insured LOC860n: <br /> Meng Monica M Men -Ha e ,DDS Sec Attached Schedule <br /> C EWII'IFICItTE HOLDFR ADDrrlONAL INSURED;INSURER LIFTER:__ CANCELLATION <br /> THIS CI:RTI F FATE IS PROVIDED AS PROOF THAT A POLICY OF INSURANCE:IS OR HAS BED;IN <br /> FORCE„IT IS NOT A GUARANTEETHAT THIS COVERAGE CONTINUES IN FORCE, FURTHERMORE. <br /> AS A CERTIFICATE HOLDER,YOU WILL 13S1Y DE PROVIDED WITH NOTICE suom,D THE <br /> INSURANCE:COVERAGF.DESCRIBED BE TEP-MINATED. <br /> Dentist's Advantage <br />