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DocuSign Envelope ID: 5D924F8F- OA84- 4ECE- 95C8- E82E8DA18036 <br />Medical Mutual" <br />PROTEc'r1NG OUR PROFESSION <br />CERTIFICATE OF INSURANCE <br />This certificate is issued as a matter of information only and confers no rights upon the certificate holder. <br />This certificate does not amend, extend, or alter the coverage afforded by the policies listed below. <br />INSURED: <br />Triangle Urology Associates PA <br />205 Frasier St <br />Durham, NC 27704 <br />COMPANY AFFORDING COVERAGE: <br />Medical Mutual Insurance Company of North Carolina <br />700 Spring Forest Road 4th Floor <br />Raleigh, NC 27609 <br />TYPE OF INSURANCE: Medical Professional Liability - Claims Made <br />POLICY NUMBER: PG113371 RETROACTIVE DATE: March 1, 1978 <br />POLICY PERIOD: <br />FROM: January 1, 2018;12:01 A.M. TO: January 1, 2019;12:01 A.M. <br />LIMITS OF LIABILITY: <br />EACH CLAIM <br />3,000,000 <br />ANNUAL AGGREGATE <br />5,000,000 <br />Date: October 25, 2017 <br />Authorized presentative <br />Certificate Holder: <br />MEDICAL MUTUAL INSURANCE COMPANY <br />PM09 (01116) OF NORTH CAROLINA SPRATLT <br />