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DocuSign Envelope ID: CDC2A722- FCCF- 4F6B- BE14- 7CAAA84F2227 <br />LASERSLIABILITY INSURANCE 5020 Weston Parkway, suite eon 1 919.677.8900 TES. <br />COMPANY OF Cary, North Carolina 27.513 800.662.8843 TOLL FREE <br />MUTUAL NORTH CAROLINA <br />Post o on Box 1329 919w.law err FAX <br />Cary; North Carolina 27.512 -11]29 www.iawyersmutualnc.com <br />Insured Listing / Prior Acts Date Endorsement <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 />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 <br />Licensing State <br />License <br />Prior Acts Date <br />(or Other) <br />Number <br />1. SAMUEL FLY COLEMAN <br />NC <br />20898 <br />12/01/1994 <br />2. ALONZO B. COLEMAN <br />NC <br />891 <br />07/01/2009 <br />3. GEOFFREY E GLEDHILL <br />NC <br />6633 <br />03/25/1977 <br />4. CYRUS QUINN GRISWOLD <br />NC <br />48844 <br />06/01/2015 <br />5. DOUGLAS HARGRAVE <br />NC <br />7142 <br />03/25/1977 <br />6. KATHERINE T MERRITT <br />NC <br />38559 <br />09/02/2008 <br />7. JASON P MURPHY <br />NC <br />39937 <br />07/05/2015 <br />8. JAMES JOHN RAINSFORD <br />NC <br />38696 <br />03/07/2012 <br />Authorized Agent <br />END #: 012 (08/0112015) Page 1 of 1 AttyUstRALE 13994 2016 <br />