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DocuSign Envelope ID:BA2C9714-6E23-4C44-906C-9D17CC0719D6 UNC SOM#22-0715 <br /> 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: Jamie Stein Smolko <br /> DATES OF COVERAGE: 04/05/2019 — 06/30/2022 <br /> NAME OF CARRIER: UNC Liability Insurance Trust Fund <br /> AMOUNT OF COVERAGE: 04/05/2019 — 06/30/2022 <br /> Covered individuals are subject to a limit of $3 million <br /> per medical incident. The total limit of liability per <br /> medical incident for all covered parties is $7 million <br /> per medical incident. All coverage is limited to <br /> medical incidents that occur in the United States of <br /> America. <br /> CURRENT POLICY TYPE: Occurrence basis <br /> POLICY NUMBER: Not applicable <br /> CLAIMS HISTORY: None <br /> Completed by: <br /> &e6t,-it J -_ 11/8/2021 <br /> Date: <br /> Stephenie Fenton-Wilhelm <br /> Vice President 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 />