Orange County NC Website
Browse       Search
DocuSign Envelope ID: 155D1985-9FE0-4EA7-1367C-E2531BEE9621 <br /> Medical Mutual <br /> P6LOIEG1 IC OldP•"ItOf <br /> COVERAGE B-ADDITIONAL INTEREST ENDORSEMENT <br /> Name and Address of Insured: <br /> Raleigh Pathology Laboratory Associates PA <br /> PO Box 14045 <br /> Raleigh,NC 27620 <br /> Additional Interest Endorsement Covers: Raleigh Pathology Laboratory Associates PA <br /> Endorsement to Policy No: PG112061 <br /> Policy Effective Date: August 15, 2015 <br /> Endorsement Effective Date: August 15, 2015 <br /> It is agreed that in Section L INSURING AGREEMENT,Coverage B.Medical Practice and <br /> Non-Physician Employee Professional Liability is amended to include, as an Insured,the <br /> professional corporation named below, except that the Limits of Liability shown in the <br /> Declarations for Coverage B are shared by the Insured covered in Coverage B and the <br /> professional corporation named below: <br /> Wake Medical Lab Consultants Inc <br /> All other terms and conditions of the policy remain unchanged. <br /> r:1/ 00, <br /> Countersigned By: 2 Date: May 15,2015 <br /> Auth elird Representative <br /> MEDICAL MUTUAL INSURANCE COMPANY <br /> PE3901NC(06/08) OF NORTH CAROLINA <br /> CAMPBEC <br />