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DocuSign Envelope ID:CC89B49F-E2DO-47EA-BO3D-9AE14E7378C8 <br /> Cl i ent #484672 <br /> MEMORANDUM OF INSURANCE ate Issued 11/01/2018 <br /> Producer This memorandum is issued as a matter of information <br /> only and confers no rights upon the holder. This <br /> Mercer Consumer, a service of memorandum does not amend, extend or alter <br /> Mercer Health& Benefi ts Admi ni strati on L L C coverages afforded by the Certificate listed below. <br /> P.O. Box 14576 <br /> Des M of nes, I A 50306-3576 <br /> 1-800-503-9230 Company Affording Coverage <br /> Insured L i berty I nsurance U nderwriters I nc <br /> North Carolina Assoc of I ns Agents I nc <br /> Robert E. Dupuis 101 Weston Oaks Court <br /> c/o N CA I A Cary NC 27513 <br /> PO Box 1165 <br /> Cary NC 27512 <br /> This is to certify that the Certificate listed below has been issued to the insured named above for the policy period indicated, not <br /> withstanding any requirement, term or condition of any contract or other document with respect to which this memorandum may be <br /> issued or may pertain,the insurance afforded by the Certificate described herein is subject to all the terms,exclusions and conditions of <br /> such Certificate.The limits shown may have been reduced by paid claims. <br /> The Memorandum of Insurance and verification of payment are your evidence of coverage.No coverage is afforded unless the premium <br /> is successfully paid in full. <br /> Type of Insurance Certificate Number Effective Date Expiration Date Limits <br /> rofessional Liability A HY-768247005 12/22/2018 12/22/2019 Per Incident/ $2,000,000 <br /> Pharmacist E Occurrence <br /> Pharmacist <br /> Annual Aggregate $4,000,000 <br /> ROOF OF INSURANCE <br /> Memorandum Holder: Should the above describe Certificate be cancelled <br /> before the expiration date thereof; the issuing company <br /> PROOF OF COVERAGE ONLY ill endeavor to mail 30 days written notice to the <br /> emorandum Holder named to the left but failure to <br /> Roll SUCH 11UL1Ce SIMI 1111pUSe 110 0011gaL1011 Of 11ab111Ly <br /> of any kind upon the compaw its age11LJ or <br /> representatives. <br /> Authorized Representative <br /> Mark Brostowitz <br /> G�VIc�-QL�Q.. <br /> Mercer Consumer, aserviceof Mercer Health& Benefits Administration LLC. In CA d/b/a Mercer Health& Benefits Insurance Services LLC. CA License#OG39709 <br />