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Authorized Representative <br />SP 1557590H <br />No. SP 1557590I <br />DISPUTE SETTLEMENT CENTER, INC. <br />302 WEAVER STREET <br />CARRBORO, NC 27510 <br />POLICY PERIOD: (MO. DAY YR.) From:To: <br />BUSINESS DESCRIPTION: <br />Customer Copy <br />12:01 A.M. STANDARD TIME AT YOUR <br />MAILING ADDRESS SHOWN ABOVE <br />IN CONSIDERATION OF THE RENEWAL PREMIUM STATED BELOW, EXPIRING POLICY NUMBER SP 1557590H IS RENEWED <br />THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. <br />NAMED INSURED AND ADDRESS: <br />Renewal of Number <br />POLICY DECLARATIONS <br />10/02/2023 10/02/2024 <br />Mediator / Training Specialist <br />*** RENEWAL CERTIFICATE *** <br />United States Liability Insurance Company <br />1190 Devon Park Drive, Wayne, Pennsylvania 19087 <br />A Member Company of United States Liability Insurance Group <br />Coverage Form(s) and Endorsement(s) made a part of this policy at time of issue <br />See Endorsement EOD (1/95) <br />Agent: BIN INSURANCE HOLDINGS, LLC. DBA INSUREON (CHICAGO) <br />(4034) <br />203 N. LaSalle Street <br />20th Floor <br />Chicago, IL 60601 <br />Issued:08/23/2023 2:01 PM <br />By: <br />UPC (08-07) <br />THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART DECLARATIONS, <br />COVERAGE PART COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, <br />COMPLETE THE ABOVE NUMBERED POLICY. <br />FOR THE POLICY PERIOD STATED ABOVE. PLEASE ATTACH THIS RENEWAL CERTIFICATE TO YOUR EXPIRING POLICY. <br />Direct Bill Policy <br />PREMIUM <br />Specified Professions Professional Liability Errors And <br />Omissions Coverage Part <br />$756.00 <br />TOTAL:$756.00 <br />DocuSign Envelope ID: C1FDB7A8-33AB-450C-8DB5-7B58DE47A409