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i DocuSign Envelope ID:EAA6285F-8A68-4540-94FF-6DOOBC770228 <br /> EASTERN DENTISTS INSURANCE COMPANY <br /> (A Dental Society Risk Retention Group) <br /> PROFESSIONAL LIABILITY PROGRAM - NOTICE TO POLICYHOLDERS <br /> CLAIMS MADE <br /> Attached to and Forming Part of Policy Number: NCC2000363-363 <br /> Issued to: Diane C. Shugars, DDS <br /> Policy Period <br /> Inception Date: 06/01/2020 Limits of Liability: $1,000,000/$3,000,000 <br /> Expiration Date: 06/01/2021 Retroactive Date: 06/01/2011 <br /> Effective Date of This Endorsement: 06/01/2020 <br /> CAUTION: NO COVERAGE IS PROVIDED BY THIS NOTICE; NOR CAN IT BE <br /> CONSTRUED TO REPLACE ANY PROVISION OF YOUR POLICY. YOU SHOULD READ <br /> YOUR POLICY AND REVIEW YOUR DECLARATION PAGE FOR COMPLETE <br /> INFORMATION ON THE COVERAGES THAT YOU ARE PROVIDED. IF THERE IS A <br /> CONFLICT BETWEEN THE POLICY AND THIS NOTICE, THE POLICY SHALL PREVAIL. <br /> Dear Policyholder, <br /> Eastern Dentists Insurance Company (EDIC) has renewed your professional liability <br /> coverage for the policy period listed above. The forms and endorsements made part of the <br /> renewal policy you have received are the same as those contained in your former policy <br /> booklet. There have been no changes in the policy coverage. <br /> A copy of the updated policy Declarations and endorsement(s) are attached. If you would <br /> like to receive a complete copy of the policy coverage, including all forms, please contact <br /> your agent or EDIC directly with your request. <br /> End of Policyholders Notice <br /> Policy CM 9-1-2017 <br /> 2020-04-27 09:46:26A <br />