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DocuSign Envelope ID: B7DABF9A- D92E- 48BA- BCOB- AFFC399D4D85 <br />CERTIFICATE OF INSURANCE MagMutual Insurance Company <br />Certificate issued to: <br />Name and mailing address of insured: <br />Family Centered Healthcare, PA <br />P.O. Box 1119 <br />Hillsborough, North Carolina 27278 <br />This is to certify that MagMutual Insurance Company has issued a Blanket Employee <br />Endorsement under the Medical Professional Liability Policy to the insured listed above, subject <br />to the provisions of the current policy contract. <br />Policy Number: Effective Date: Expiration Date: <br />PSL 170197910 2/1/2o18 2/1/2019 <br />Shared Limits of Liability: <br />$1,000,000 Each loss limit <br />$3,000,000 Aggregate limit <br />Covered Employee(s): <br />Lisa Smoot, FNP <br />Tara Walhart, NP <br />This document is issued as a matter of information only and confers no rights upon the document <br />holder. This document does not amend, extend, or alter the coverage, terms, exclusions, <br />conditions, or other provisions afforded by the policies referenced herein. <br />Please inquire directly with the insured for individual restrictive endorsements that may apply. <br />In the event of cancellation of the described policy, MagMutual Insurance Company will make <br />reasonable effort to notify the party at whose request this certificate was issued, but MagMutual <br />Insurance Company shall not be liable in any way for failure to give such notice. <br />CI -ESPB Ed. o8/16 <br />Ed Lynch <br />Authorized Representative <br />February 8, 2018 <br />MagMutual Insurance Company <br />P.O. Box 52979 <br />Atlanta, GA 30355 -0979 <br />