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. _ . <br /> DocuSign Envelope ID:3DAF2DFC-999B-4C15-9AAF-83B41A879CDB n ,1A879CDB 'ra "- v-umPonY Policy Number <br /> S 1940885 <br /> SELECTIVE INSURANCE COMPANY OF SOUTH CAROLINA <br /> 3426 TORINGDON WAY, CHARLOTTE, NC 28277 <br /> CO I RCIAL POLICY CO I ON DECLARATION <br /> Named Insured and Address Policy Period <br /> RALEIGH PATHOLOGY LABORATORY ASSOCIATES PA 8 WAKE MED From JUNE 7, 2017 <br /> L ABORAI ORY CORP To: JUNE 7, 2018 <br /> PO BOX 14045 <br /> RALEIGH, NC 27620-4045 <br /> 1 t2:0$ A m Standard'lime At <br /> Locabon of Des ated Premises. 2 <br /> Named insured is; Producer Number: <br /> CORPORATION 00-07265-00000 <br /> Producer: <br /> SENTINEL RISK ADVISORS, LLC <br /> NORTH CAROLINA <br /> Schedule of Coverage <br /> BUSINESSOWNERS COVERAGE <br /> COMMERCIAL UMBRELLA COVERAGII <br /> 0 <br /> •••■• <br /> xxxowfm■ <br /> .1■1 <br /> ..■- <br /> ■1•11111 <br /> PREMIUM INCLUDES TERRORISM — CERTIFIED ACTS <br /> In return for pa nt of the premium, and subject to all the terms uf this policy, we a: with <br /> you to provide the insurance indicated in the schedule above. Insurance is provided only fo those <br /> coverages for which a ilk limit is shown on the at el covers:e deelaratiel4)- <br /> PAYMENT METHOD T. Policy iun, <br /> D/B — 4 (I his pr- slum y be subject ba adjustment.) <br /> Date issued: APRIL 21, 2017 <br /> Issuing ce: SERVICE CENTER <br /> Authorized Representative <br /> IL-7025 (11/89) <br /> INSURED'S COPY <br />