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DocuSign Envelope ID:8DFE3563-3EA6-49C3-9418-789DA859B935 <br /> 1k r c LIABILITY INSURANCE 5020 Weston Parkway,suite 200 919.677.8900 ru. <br /> Y v <br /> COMPANY OFL Cary,North Carolina 27,I3 <br /> 800.662.8843 coil race <br /> J r T Post Office Box 1929 919.677.9641 rnx <br /> NORTH CAROLINA Cary,North Carolina 27512-1929 www.law}ersnnitualnc.com <br /> Insured Listing / Prior Acts Date Endorsement <br /> ( <br /> This Endorsement, effective 12:01 A.M. on 12/01/2016 forms a part of Policy No, 0013994 - 27 (the <br /> "Policy") issued by LAWYERS MUTUAL LIABILITY INSURANCE COMPANY OF NORTH CAROLINA and <br /> applies to COLEMAN GLEDHILL HARGRAVE MERRITT& RAINSFORD PC (the "Named Insured"), <br /> is <br /> ( <br /> It is hereby understood and agreed that as to each Insured listed below, this Policy shall not apply <br /> to such Insured's act(s) or omission(s), or series of related act(s) or omission(s), occuring or <br /> beginning prior to the date listed individually for each Insured below("Prior Acts Date"). <br /> All Policy provisions, terms, exclusions, and conditions, except as provided otherwise in this <br /> Endorsement, remain in full force and effect. <br /> Name Licensing State License Prior Acts Date <br /> (or Other) Number <br /> 1. SAMUEL ELY COLEMAN NC 20898 12/01/1994 <br /> 2, ALONZO B. COLEMAN NC 891 07/01/2009 <br /> 3. GEOFFREY E GLEDHILL NC 6633 03/25/1977 <br /> 4, CYRUS QUINN GRISVVOLD NC 48844 06/01/2015 <br /> 5, DOUGLAS HARGRAVE NC 7142 03/25/1977 <br /> 6. KATHERINE T MERRITT NC 38559 09/02/2008 <br /> • <br /> 7, JASON P MURPHY NC 39937 07/05/2016 <br /> 8. JAMES JOHN RAINSFORD NC 38696 03/07/2012 <br /> • <br /> is <br /> A,,_ <br /> _ , <br /> Authorized Agent <br /> j <br /> END#: 012 (08/01/2015) Page 1 of 1 AttyLIStPALE 13994 2016 <br /> ii <br />