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DocuSign Envelope ID: 7D9491 BE-DD6D-4897-B77A-CD2FD6CC19A7 <br /> Client# 484672 <br /> MEMORANDUM OF INSURANCE ate Issued 12/22/2014 <br /> Producer This memorandum is.issued as a matter of information <br /> only and confers no rights upon the holder, `I'`hi <br /> Mercer Consumer, a service of ineinorwiduni does not amend, extend or alter <br /> Mercer Health& Benefits Administration LLC coverages afforded by the Certificate listed below. <br /> P.O. Box 14576 <br /> Des Moines, IA 50306-3576 <br /> 1-800-503-9230 Company Affording Coverage <br /> Insured Liberty Insurance Underwriters Inc <br /> North Carolina Assoc of Ins Agents Inc <br /> Robert E. Dupuis 101 Weston Oaks Court <br /> c/o NCAIA Cary NC 27513 <br /> PO Box 1165 <br /> Cary NC 27512 <br /> This is to certify that the Certificate listed below has been issued to the insured named above for the policy period indicated_ <br /> not withstanding any requirement, term or condition of any contract or other document with respect to which this <br /> memorandum may be issued or may pertain, the insurance afforded by the Certificate described herein is subject to all the <br /> terms, exclusions and conditions of such Certificate.The limits shown may have been reduced by aid claims. <br /> Type of Insurance Certificate Number Effective Date Expiration Date Limits <br /> Professional Liability AHY-768247001 12/22/2014 12/2212015 Per Incident/ $2,000,000 <br /> Pharmacist E Occurrence <br /> Pharmacist <br /> Annual Aggregate $4 000,000 <br /> PROOF OF INSURANCE <br /> Memorandum.Holder: Should the above describe Certificate be cancelled <br /> before the expiration date thereof,the issuing company <br /> PROOF OF COVERAGE ONLY will endeavor to mail 30 flays written notice to the <br /> Memorandum Holder named to the left, but failure to <br /> mail such notice shall impose no obligation or liability <br /> f any bind upon the company, its agents of <br /> representatives. <br /> Authorized Representative <br /> Mark Brostowitz <br /> Mercer Consumer,a service of Mercer Health&Benefits Administration LLC. In CA dibla Mercer Health &Benefits Insurance Services LLC,CA Lie.*OG39709 <br />