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DocuSign Envelope ID:97238CE2-BA88-43FC-BB15-3276F9D37D17 <br /> EASTERN DENTISTS INSURANCE COMPANY <br /> (A Dental Society Risk Retention Group) <br /> CERTIFICATE OF INSURANCE <br /> This certificate is issued as a matter of information only and confers no rights upon the certificate <br /> holder.This certificate does not amend,extend,or alter the coverage afforded by the policies listed <br /> below. <br /> INSURED: <br /> Diane C. Shugars, DDS <br /> 4321 Fearington Post <br /> Pittsboro, NC 27312 <br /> COMPANY AFFORDING COVERAGE: <br /> Eastern Dentists Insurance Company <br /> 200 Friberg Parkway, Suite 2002 <br /> Westborough, MA 01581 <br /> TYPE OF INSURANCE: Claims Made Professional Liability <br /> POLICY NUMBER: NCC1900363 <br /> RETROACTIVE DATE: 06/01/2011 <br /> POLICY PERIOD: <br /> FROM: 06/01/2019 ; 12:01 A.M TO: 06/01/2020 ; 12:01 A.M. <br /> LIMITS OF LIABILITY: <br /> EACH <br /> nCLAIM <br /> �7 ANNUAL AGGREGATE <br /> $ 1,000,000 $ 3,000,000 <br /> _ Date issued: April 2, 2019 <br /> Sheila Anxu ni, Esq. <br /> President and CEO <br /> Eastern Dentists Insurance Company <br /> 200 Friberg Parkway,Suite 2002,Westborough, MA 01581-3999 <br /> 1-800-898-3342 • 508-836-4204• 508-836-9910 Fax • www.edic.com <br />