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DocuSign Envelope ID: 3FD37DED-3EFC-49BB-BD08-D6EFCA4FEB76 <br /> Policy Form: SM-20003-01 04108-Specified Med Professions General <br /> Liability Insurance(Including Products and Completed Operations Liability)-Claims <br /> Made <br /> Specified Med Professions Professional Liability Insurance-Claims Made(claims <br /> made form) <br /> Professional Liability: <br /> Professional Services: Adult Day Care <br /> Note: The Professional Liability Insurance Coverage Part contains provisions that <br /> reduce the limits of liability stated in the policy by the costs of legal defense and permit <br /> legal defense costs to be applied against the deductible, unless the policy is amended <br /> by endorsement <br /> General Liability: <br /> *Coverage A. Bodily Injury and Property Damage Liability <br /> 1 Coverage A: $50,000 damage to premises-any one premise <br /> i3Coverage B: Personal Injury and Advertising injury Liability <br /> `Coverage C: Medical Payments -Each Injured Person <br /> Specified Products,Goods,Operations and Premises: Adult Day Care Services,all <br /> related premises and operations of the Insured <br /> The Premises Hazard and Operations Hazard excludes all pollution cleanup. <br /> Note: The General Liability Insurance Coverage Part contains provisions that reduce <br /> the limits of liability stated in the policy by the costs of legal defense and permit legal <br /> defense costs to be applied against the deductible,unless the policy is amended by <br /> endorsement <br /> Extended Reporting Period (bi-lateral): 12/24/36 months for 150%1175%/200%of the <br /> total annual premium,respectively <br /> Up to 7 years Extended Reporting Period available:See Endorsement MEIL 5229 09 <br /> 10,attached. <br /> Endorsements: EIC 4115-01 25%Minimum Earned Premium Endorsement <br /> EIC 832-01 Asbestos Exclusion <br /> ZZ-44002-01 Mold Exclusion <br /> MEIL 5229 09 10 Longer Duration Extended Reporting Period Availability <br /> EIC 4638 01 15 Certified Acts of Terrorism Endorsement <br /> MEIL 5410 02 12 Amendment of Definitions and Exclusions-Electronic <br /> Data and Distribution of Material in Violation of Statutes <br /> MEIL 1313 0212 Amendment of Definitions and Exclusions-Electronic <br /> Data and Distribution of Material in Violation of Statutes <br /> MEIL 1228 0214 Non-Stacking Limitation When Two Or More Policies Apply <br /> ZZ 50000 0115 Policyholder Disclosure Notice of Terrorism Insurance <br /> Coverage <br /> MESM 3017 0515 Exclusion-Unmanned Aircraft <br /> EIC 4661 Additional Insured Endorsement for Landlords,Sponsors <br /> or Lessors <br /> MESM 2098 0414 Good Samaritan Endorsement <br /> MESM 2034 04 11 DataBreach Coverage Parts Endorsement <br />