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. Physicians <br />Insurance <br />A MUTUAL COMPANY <br />1301 second Avenue, Suite 2700 <br />PO Box 91220 <br />Seattle, NSA 98111 <br />( 206) 343-73!00 <br />(800) 962-1399 <br />F (206) 343-7100 <br />CONFIRMATION OF INSURANCE COVERAGE <br />PROFESSIONAL LIABILITY INSURANCE POLICY <br />CLAIMS -MADE <br />Named Insured: Elkhorn Valley Corp dba Family Health Care Policy Number: <br />of Ellensburq <br />Paramedical Employee: Ryan Beachy, PA -C Reference Number: <br />Mailing Address: 107 E Mountain Vw Ave Ste 1 <br />Ellensburg, WA 98926 <br />POLICY PERIOD: January 1, 2018 to January 1, 2019 <br />at 12:01 a.m, local time at the address shown above <br />RETROACTIVE DATE: February 4, 2009 <br />This document will confirm that Physicians Insurance A Mutual Company (the <br />Company) provides professional liability insurance to Ryan Beachy, PA -C, <br />subject to the Company's minimum liability limits of $1,400,000 each medical <br />incident and $5,000,000 aggregate. <br />The certificate of insurance is issued as a matter of information only and confers <br />no rights upon the certificate holder. This confirmation does not amend, extend or <br />otherwise alter the terms, conditions or limits of the insurance afforded by the <br />policy. If the Policy, or coverage for any person, is canceled for any reason or if <br />the terms of the policy are changed, we will notify the Named Insured only. <br />This confirmation was issued on November 10, 2017. <br />042253000 <br />240453 <br />To our Insureds: This confirmation of coverage is provided for your use for hospital privilege requirements, <br />HMOs, PPOs, etc. You are authorized to photocopy and distribute as needed without further permission <br />from or notification to the Company. <br />240453 <br />Col -P1.08071 2 <br />73 240453 002258 <br />