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DocuSign Envelope ID:93039227-0C40-4DA1-8CBE-17FBAOEE6AEE <br /> CERTIFICATE OF INSURANCE <br /> REVISED 6-5-2016 <br /> Named Insured: North Carolina Association of Local Health Directors <br /> Alamance County Health Department <br /> This is to certify that the policies of insurance listed below have bee issued to the insured named <br /> above for the policy period indicated. Notwithstanding any requirement,term or condition of any <br /> contract or document with respect to which this certificate may be issued or may pertain,the <br /> insurance afforded by the policies described herein is subject to all terms,exclusions,and <br /> conditions of such policies. <br /> Company: Policy# Policy Term_ <br /> ACE Medical Risk-Ace American Insurance MLP G21686037-14 7/1/2016-7/1/2017 <br /> Coverage: Claims Made Miscellaneous Medical Professional Liability <br /> Limit: $1,000,000 each claim/$3,000,000 annual aggregate <br /> $20,000,000 policy aggregate <br /> Deductible: $5,000 per claim <br /> Retroactive Date: 7/1/2000 <br /> Additional Named Insured: Retroactive Date: <br /> Karen Saxer,CNM 8/1/2005 CNM <br /> Carla Jean Hampton,PA 7/1/2000 PA <br /> Elizabeth A. Sciora,CNM 7/1/2000 CNM <br /> Westside OB/GYN Additional Insured <br /> Elizabeth Krzysztoforska,DDS 5/1/1998 DDS <br /> UNC,Chapel Hill S of Nursing 11/5/2005 <br /> UNC,Chapel Hill S of Dentistry Additional Insured <br /> UNC-G S of Nursing Additional Insured <br /> Cassa Emery,Dental Hygienist 1/13/2010 <br /> James Fetner,DDS 7/9/2012 DDS <br /> Suzanne Walker,RPh 12/1/2006 RPh <br /> Amanda Marvin,LCSW-A 9/2/2014 LCSW-A <br /> Nicole Alston,RD 5/3/2010 RD <br /> Janice Putnam,RD 12/31/2012 RD <br /> Donna Dotson,RD 4/13/1994 RD <br /> Isa Cheren,MD/LT NCPHA <br /> Cynthia Latta,NP NCPHA <br /> Annamarie Streilein,PA NCPHA <br /> Should the above described policy be cancelled before the expiration date thereof,the issuing company will endeavor to <br /> mail 30(Thirty)days written notice to the Insured named above. <br /> The coverage represented by this certificate is subject to the terms,conditions and limitations of the policies in current <br /> use by the carrier named above. <br /> The Snowden Company,LLC Date 6/5/2016 <br /> Terrie I. Snowden,CPCU <br />