Laserfiche WebLink
® Issuing Company: <br /> 1■ MedPro Group National Fire & Marine Insurance Company <br /> a Berkshire Haiha ycompany Omaha, Nebraska <br /> Forming Part of Policy No.: HN033337 <br /> Issued to: Industrial Medical Support, Inc <br /> Policy Period: From 03/15/2026 to 03/15/2027 at 12:01 a.m. at the address of the First Named <br /> Insured stated herein. <br /> SCHEDULE OF FORMS AND ENDORSEMENTS <br /> Forms and Endorsements attached to this Policy: <br /> ENDORSEMENT <br /> FORM NAME FORM NUMBER NUMBER <br /> Healthcare Liability Policy Declarations 0001-PXX-00-0121 <br /> Schedule of Forms and Endorsements 0002-PXX-00-1215 <br /> Schedule of Named Insureds - Professional Liability 0006-PPX-00-1215 <br /> Schedule of Named Insureds -General Liability 0007-PGX-00-0717 <br /> Schedule of Named Insureds -Cyber Liability and Breach Response 0008-PCX-00-0121 <br /> Schedule of Trade, Fictitious and/or Business Names 0009-PXX-00-1215 <br /> Healthcare Liability Policy Common Policy Provisions and Conditions 0010-PXX-00-0121 <br /> Healthcare Liability Policy- Professional Liability Coverage Part 0011-PPF-00-0121 <br /> Healthcare Liability Policy-General Liability Coverage Part 0012-PGX-00-0121 <br /> Healthcare Liability Policy-Cyber Liability and Breach Response Coverage Part 0013-PCX-00-0121 <br /> Schedule of Additional Insureds Endorsement 1120-PXX-00-0121 1 <br /> Schedule of Additional Insureds- Primary and Non-Contributory with Notice of 1123-PXX-00-0121 2 <br /> Cancellation Endorsement <br /> Schedule of Waiver of Subrogation Endorsement 1128-PXX-00-1215 3 <br /> Amended Definition of Employee Endorsement 1136-PXX-00-0121 4 <br /> Policy Aggregate Limit Endorsement(Professional Liability&General Liability) 1173-PXX-00-0121 5 <br /> Disciplinary, Licensing and Credentialing Actions Endorsement(Professional 1303-PPX-00-0121 6 <br /> Liability) <br /> Intentional Acts Exclusion with Sublimits for Innocent Insureds Endorsement 1318-PPF-00-0121 7 <br /> (Professional Liability) <br /> Blanket Restricted Practice - Covered Practice Endorsement(Professional 1338-PPX-00-0121 8 <br /> Liability) <br /> Blanket Per Location Limits of Liability Endorsement(Professional Liability) 1357-PPX-00-0121 9 <br /> Employee Benefits Liability Endorsement(General Liability) (Claims-Made and 1504-PGX-00-0121 10 <br /> Reported Coverage) <br /> Blanket Additional Insured - Primary and Non-Contributory Endorsement 1507-PGX-00-0121 11 <br /> (General Liability) <br /> Blanket Waiver of Subrogation Endorsement(General Liability) 1512-PGX-00-1215 12 <br /> 0002-PXX-00-1215 Page 1 of 2 © 2015 MedPro Group. All rights reserved. <br />