Orange County NC Website
DocuSign Envelope ID: 167F763C-D16E-41 D3-B98F-F5E24EE9CC37 <br /> CI i ent #2271544 <br /> MEMORANDUM OF INSURANCE Date Issued 03/27/2017 <br /> Producer This memorandum is issued as a matter of information <br /> only and confers no rights upon the holder. This <br /> Mercer Consumer, a service of memorandum does not amend, extend or alter <br /> Mercer Health& Benefits Administration LLC coverages afforded by the Certificate listed below. <br /> P.O. Box 14576 <br /> Des Moines, IA 50306-3576 <br /> 1-800-503-9230 Company Affording Coverage <br /> Insured Liberty Insurance Underwriters Inc <br /> M el ynee M Fal k <br /> 803 Seven Oaks Drive <br /> Greensboro NC 27410 <br /> This is to certify that the Certificate listed below has been issued to the insured named above for the policy period indicated, <br /> not withstanding any requirement, term or condition of any contract or other document with respect to which this <br /> memorandum may be issued or may pertain, the insurance afforded by the Certificate described herein is subject to all the <br /> terms, exclusions and conditions of such Certificate. The limits shown may have been reduced by paid claims. <br /> Type of Insurance Certificate Number Effective Date Expiration Date Limits <br /> Professional Liability AHY-860875001 04/01/2017 04/01/2018 Per Incident/ $1,000,000 <br /> SpeechLangH SE Occurrence <br /> Speech Language Pathologist <br /> Annual Aggregate $3,000,000 <br /> PROOF OF INSURANCE <br /> Memorandum Holder: Should the above describe Certificate be cancelled <br /> before the expiration date thereof,the issuing company <br /> PROOF OF COVERAGE ONLY will endeavor to mail 30 days written notice to the <br /> Memorandum Holder named to the left, but failure to <br /> mail such notice shall impose no obligation or liability <br /> of any kind upon the company, its agents or <br /> representatives. <br /> Authorized Representative <br /> Mark Brostowitz <br /> �Y l a -QL Q. ' ,;-•raw! <br /> Mercer Consumer, a service of Mercer Health& Benefits Administration LLC. I n CA d/b/a Mercer Health& Benefits Insurance Services LLC. CA Ins L i c. #0G39709 <br />