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The Medical Protective Company® <br />ASTOCK INSURANCE COMPANY <br />5814 Reed Road,Fort Wayne,Indiana 46835 <br />Strength.Defense.Solutions.Since 1899. <br />MULTI-SPECIALTY HEALTHCARE PROFESSION4L <br />MASTER POLICY <br />SCHEDULE OF INSUREDS ENDORSEMENT <br />Item l(a)of the CERTIFICATE is as follows: <br />ITEM 1(a)NAMED INSURED PROFESSIONAL SERVICES <br />SPECIALTY <br />TYPE MODIFIED PREMIUM <br />RETROACTIVE I)Individual COVERAGE SURCHARGEDATE*E)Entity ENDORSEMENT TAXES <br />CLASS (If Applicable)S)Student NUMBER (If Applicable) <br />Ellensburg Family Medicine <br />E Not Applicable included <br />Each employee,shareholder,partner,volunteers or <br />independent contractor Healthcare Professional of <br />EIIensburg Family Medicine but only while providing <br />professional services on behalf or under the direction or <br />control of Ellensburg Family Medicine excluding any <br />physician,podiatrist,chiropractor,optometrist,nurse <br />rnidwife,certified registered nurse anesthetist or dentist I Not Applicable included <br />unless designated as an [nsured under your Certificale <br />or by endorsement listed on your Certificate. <br />Item 1(b)of the CERTIFICATE is as follows: <br />PREMIUM <br />AFFILIATED ITEM 1(a)NAMED SURCHARGEITEM1(b)ADDITIONAL INSURED INSURED TAXES <br />(lf Applicable) <br />Kittitas County All 1(a)Named Insureds Listed Above Included <br />Kittitas County All 1(a)Named Insureds Listed Above Included <br />All other terms and conditions of the Policy remain unchanged. <br />18505 08/13