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DocuSign Envelope ID: 17C156AE-5EFE-4837-87B8-36CA89E13B8C <br /> PROTECTOR PLAN I PROFESSIONAL PROTECTOR PLAN <br /> F D R D E DI T I S T 3 <br /> PROFESSIONAL LIABILITY COVERAGE PART <br /> DENTISTS/ORAL SURGEONS OCCURRENCE <br /> DECLARATIONS <br /> Policy Number From Policy Period To Coverage Is Provided By <br /> D022132-02 09/18/2018 09/18/2019 Aspen American Insurance Company <br /> Named Insured and Address National Administrator <br /> Brian James Swift DDS B & B Protector Plans Inc. <br /> P.O. Box 173569 <br /> Tampa, FL 33672-3569 <br /> 4010 Sweeten Creek Rd. State Administrator <br /> Chapel Hill, INC 27514 APP/PPP - NC <br /> P O Box 172057, <br /> Tampa FL - 33672 <br /> Limits of Liability Coverage <br /> $1,000,000 Each Claim <br /> $3,000,000 Aggregate Professional Liability-Occurrence <br /> Included Personal Injury Liability&Advertising Injury Liability-Occurrence <br /> $10,000 Each Person First Aid - Occurrence <br /> $25,000 Each Claim Employment Practices Liability Coverage Defense- Claims-Made <br /> $25,000 Aggregate <br /> $589.00 Policy Premium <br /> Printed Endorsements Attached At Policy Issuance-See Attached Schedule of Endorsements <br /> This policy shall not be valid unless countersigned by a duly authorized representative of the company. <br /> Countersigned By <br /> Authorized Representative <br /> Issue President Secretary Date: 08/17/2018 04:30:27 PM Renewal Conversi <br /> DBOZANT <br /> ASPDTPLO56 0317 Page 1 of 1 <br />