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The University of North Carolina Liability Insurance Trust <br /> Legal Department Telephone:(984)974-3041 <br /> UNIVERSITY OF NORTH CAROLINA HOSPITALS Facsimile:(984)974-6285 <br /> 101 Manning Drive,2nd Floor,Wing E <br /> Chapel Hill,NC 27514 <br /> CONFIRMATION OF INSURANCE COVERAGE FOR PROFESSIONAL LIABILITY <br /> This Confirmation of Insurance Coverage is being issued specifically to verify <br /> professional liability coverage for the referenced insureds while practicing within the <br /> scope of their employment responsibilities during the dates of coverage noted. This <br /> information should be treated confidentially. <br /> INSURED: Dawn Cherie Culmer, ANP <br /> DATES OF COVERAGE: 11/16/04—06/30/16 <br /> NAME OF CARRIER: UNC Liability Insurance Trust Fund <br /> AMOUNT OF COVERAGE: 11/16/04—06/30/16 <br /> Covered individuals are subject to a limit of$3 million <br /> for all damages against a covered individual arising <br /> out of a single claim. The total limit of liability for all <br /> loss arising out of a single claim is $7 million <br /> regardless of the number of insureds involved. <br /> CURRENT POLICY TYPE: Occurrence basis <br /> POLICY NUMBER: Not applicable <br /> CLAIMS HISTORY: None <br /> Completed by: <br /> ` 5/13/2016 <br /> Date: <br /> Jill irneisen, BSN, JD <br /> Associate V.P. of Risk Management, <br /> Accreditation & Regulatory Affairs <br /> University of North Carolina Hospitals and the School of Medicine of the University of North Carolina at Chapel Hill <br />