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The Medical Protective Company° <br />A STOCK INSURANCE COMPANY <br />5814 Reed Road, Fort Wayne, Indiana 46835 <br />Strength. Defense. Solutions. Since 1899. <br />MULTI -SPECIALTY HEALTHCARE PROFESSIONAL <br />MASTER POLICY <br />CERTIFICATE OF INSURANCE <br />SCHEDULE OFPOLICYFORMS & ENDORSEMENTS <br />Forms and Endorsements of your Certificate are as follows: <br />Form # Description <br />Form Be. ITitle <br />IMCL <br />(Cover Letter <br />118011 <br />IMPS Multi -Specialty Healthcare Professionals Policy Certificate <br />118507 <br />IMPS Multi -Specialty Healthcare Professionals Form 6 Endorsement Schedule <br />118505 <br />IMPS Multi -Specialty Healthcare Professionals Policy Schedule of Insureds <br />118511 <br />[General Definitions <br />118519 <br />IGeneral Conditions <br />118522 <br />IGeneral Exclusions 1 <br />118528 <br />(Professional Liability Insuring Agreement - Occurrence <br />118560 <br />Commercial General Liability Insuring Agreement - Occurrence <br />118617 <br />]Disclosure Notice of Terrorism Insurance Coverage <br />118620 <br />(Cap on Losses From Certified Acts of Terrorism Endorsement <br />118565 <br />(Additional Insured - Lessors of Premises & Leased Equipment <br />119120 <br />IMPS Economic Sanctions Exclusion Endorsement <br />119121 <br />(Economic Sanctions Exclusions Endorsement (GL) <br />119098 <br />IMPS Blanket Separate Limit Endorsement - PL Only <br />119187 <br />(Biomedical Waste Hearing Expense Endorsement - Occurrence <br />119218 <br />(Reuse or Multidose Supply Procedure Exclusion Endorsement <br />119631 <br />(Procedures Exclusion Endorsement <br />118752 <br />(Washington Amendatory Endorsement I <br />18507 All other terms and conditions of the Policy remain unchanged. 08/13 <br />