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ADDITIONAL COVERAGES <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Professional Liab$1M OCC/$2MAGG <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> 1,000,000 2,000,000 <br /> Ref# Description Coverage Code Form No. Edition Date <br /> AACSL AACSL <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> 2,000,000 $146.00 <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Uninsured motorist combined single limit UMCSL <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> 1,000,000 <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Blanket Additional Insured BLKAI <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> $75.00 <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Medical payments MEDPM <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> 5,000 <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> Ref# Description Coverage Code Form No. Edition Date <br /> Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium <br /> rOFADTLCV Copyright 2001,AMS Services,Inc. <br />