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DocuSign Envelope ID:93AA8ACD-CC81-4B23-B690-5COAEAFBB06E <br /> S LIABILITY INSURANCE 5020 Weston Nrkva,ay, Suite 200 919,677.8900 rEE <br /> LAYER <br /> COMPANY ❑� (7,jry, Nt.irlh C'jrulit)a 27511 800.662,8843 uni jim <br /> Post Office Box 1929 919.677.9641 FAX <br /> MUTUAL NORTH CAROL I NA Cary, Norll,Carollil.l ?7512-1929 .4,ti..1,,1 E rsmulu,,lnr.rum <br /> Insured Listing 1 Prior Acts Date Endorsement <br /> This Endorsement, effective 12:01 A.M. on May 1,2018 forms a part of Policy No. 0012116-LPL-34(the <br /> "Policy") issued by LAWYERS MUTUAL LIABILITY INSURANCE COMPANY OF NORTH CAROLINA and <br /> applies to EPTING & HACKNEY(the"Named Insured"). <br /> It is hereby understood and agreed that as to each Insured listed below, this Policy shall not apply to <br /> such insured's act(s) or ornission(s), or series of related act(s) or ornission(s), occuring or beginning <br /> 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 Licensing State License Prior Acts Date <br /> or Other Number <br /> 1 ROBERT L EPTING NC 1349 05-01-1978 <br /> 2 JOHN J HACKNEY NC 1814 05-01-1978 <br /> 3 ELIZABETH LACKEY JACOBS NC 9913 02-01-1981 <br /> 4 ROBERT STEVENSON LACKEY JR NC 23236 10-01-2012 <br /> 5 HATHAWAY STEELE PENDERGRASS NC 45045 09-28-2012 <br /> 6 ELLEN BRADSHAW SCOUTEN NC 8496 01-01-2018 <br /> A uthurued A.s al <br /> END #:012 (a81a112m5) Attyll-WPALE <br />