My Account Documents Dec Page
Professional Insurance Exchange Mutual, Inc.
D-27240 POLICY NO.
Class II-AP
DECLARATIONS
| 1. NAME OF INSURED | SCHEDULE | ||
|---|---|---|---|
|
Individual Professional Liability Claims-Made Coverage Frandsen Dental of Orem |
RETROACTIVE DATE April 19 2025 |
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2. A POLICY FROM April 19 2025 to April 19 2026 12:01 a.m. standard time issued to the Named Insured stated herein. |
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| In consideration of the premium cited below and paid by the Insured, professional liability coverage is extended as indicated by specific premium charge or charges. The limit of the Company’s liability related to coverage extended shall be subject to all terms of the Policy referenced. Coverage applies to incidents occurring after the Retroactive Date listed and claims reported to the Company in writing by the insured or by claimants during the time period listed in #2 above. | |||
| COVERAGES | LIMITS OF LIABILITY | PREMIUM |
|---|
|
Professional Liability Claims-Made Form Class II-AP |
Each Claim $1,000,000 |
Annual Aggregate $3,000,000 |
Annual Premium $100 |
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Authorized Signature CEO |
Rate Type: New Member Coverage Annually Payment Schedule |
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