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HomeMy WebLinkAboutAgenda - 10-04-1993 - III-D 1 ORANGE COUNTY BOARD OF COMMISSIONERS Action Agenda Item No. M1-13 ACTION AGENDA ITEM ABSTRACT Meeting Date: October 4, 1993 SUBJECT: Professional Service Contract for Breast and Cervical Cancer Control Program. - DEPARTMENT: HEALTH PUBLIC HEARING: Yes X No ATTACHMENT(S) : INFORMATION CONTACT: HEALTH DIRECTOR'S OFFICE X2411 1) Mammography Service Contract 2 ) Colposcopy Service Contract TELEPHONE NUMBER: Hillsborough -732-8181 Chapel Hill -968-4501 Mebane -227-2031 Durham -688-7331 PURPOSE: To approve Mammography and Colposcopy Service Contracts for patients of the Health Department' s Breast and Cervical Cancer Control Program. BACKGROUND: The Board of Commissioners approved, at its meeting of January 19, 1993, an expansion of the state contract to include the Comprehensive Breast and Cervical Cancer Control Program. Continuation funding for this project for FY93-94 was approved by the Commissioners at its meeting of April 20, 1993. The initial phase of planning the project and negotiating contracts for referral services is drawing to close. Before actually implementing the service, the attached contracts must be approved. The contracts are modeled after draft documents provided by the state, but have incorporated modifications recommended by the County Attorney and the County Purchasing Director. Funding for these contracts is included in the approved contract with the State. No local funds are involved. RECOMMENDATION(S) : The County Manager recommends that the contracts be approved and the Chair authorized to sign. STATE OF NORTH CAROLINA ORANGE COUNTY MAMMOGRAPHY SERVICE CONTRACT FOR THE 3--D ORANGE COUNTY HEALTH DEPARTMENT 1KJ AST AND CERVICAL CANCER CONTROL PROGRAM Whereas the Centers for Disease Control has awarded funds to the North Carolina Department of Environment, Health and Natural Resources for the purpose of early detection of breast and cervical cancer for low-income women in the state, and Whereas the Department of Environment, Health and Natural Resources has awarded funds to the Orange County Health Department to assure the provision of services on the local level through the implementation of a Breast and Cervical Cancer Control Program (BCCCP) , and Whereas it is necessary for Orange County Health Department to contract for the provision of screening and diagnostic mammography services, and Whereas the Centers for Disease Control has mandated certain standardized requirements, Now, therefore, the Orange County Health Department and local provider/contractor, as specified below, agree as follows : • This agreement, entered into on IN-44 (11: 013 by and between the Orange County Health Department, hereinafter called the "Department, " and the Chapel Hill Radiology, PA, hereinafter called the "Contractor, " shall commence on and shall be renewable annually. This agreement shall be for the purpose of providing mammography services to clients referred to the Contractor by the Department under the following conditions. I. The Contractor agrees to: A. Provide screening and repeat mammograms at a cost of $55 . 00 per client. This fee includes both the radiologist ' s fee and the cost for taking the screening mammogram. Screening and repeat mammography shall be defined as 2 views of each breast in asymptomatic women. B. Provide diagnostic mammography at a cost of $55 . 00 per client. Diagnostic mammography shall be indicated for women over 40 years of age who are referred by the clinician because of abnormal findings on clinical breast examination or for women found to have abnormal screening mammograms . C. The Contractor shall provide documentation of current mammography accreditation by the American College of Radiology (ACR) . Page 1 of 4 D. The Contractor shall provide documentation of being certified by the Federal Health Care Financing Administration to provide screening mammography services. E. The Contractor agrees to see clients referred by the Department for a screening mammogram no later than 6 weeks after receipt of referral. The Contractor also agrees to perform repeat diagnostic mammography on clients referred by the Department with symptoms or on clients referred by the Department whose screening mammograms indicate the need for further evaluation no later than 2 weeks after receipt of the referral . F. The Contractor shall report the mammography results of the clients referred to the Contractor by the Department to the Department using the lexicon recommended by the ACR. For results that are "Normal" on a screening or repeat mammogram and "Negative, " "Benign" or "Probably Benign" on a diagnostic mammogram the Contractor shall notify the Department of results by mail no later than two weeks after performing the mammogram. For screening or repeat mammograms that indicate the need for further evaluation and for diagnostic mammograms that are "Suspicious" or have a "High Probability of Malignancy, " the Contractor shall notify the patient ' s primary care physician and the Department of the results by phone or fax within 3 days of the service being rendered, and shall send the written report by mail to the patient' s primary care physician and to the Department within 1 week of the service being rendered. G. The Contractor shall have professional liability insurance coverage with no less than a $1,000, 000 liability limit and shall provide proof of such coverage to the Department prior to contract commencement. H. The Contractor shall bill Medicaid directly when providing Mammography for clients referred through the Breast and Cervical Cancer Control Program (BCCCP) who have Medicaid as their designated payment source. The Contractor shall bill the Department when providing mammography for clients referred through BCCCP who have the Department' s BCCCP as their designated payment source. I. The Contractor is prohibited from billing clients for any additional charges for the performance of Mammography. Page 2 of 4 II . The Department agrees to: A. Pay the Contractor $55 . 00 for screening and repeat mammograms and $55 . 00 for diagnostic mammograms for women referred by the Department who have the Department ' s Breast and Cervical Cancer Control Program as their designated source of payment. III. Termination This agreement between the Department and the Contractor for the provision of Mammography services to clients referred by the Department may be terminated by either party with 60 days written notice, except in the case of breach of contract, in which case, termination can be immediate. IV. Notice Any notice required by this agreement will be complete upon being deposited in a depository of the US Postal Service with 1st class postage addressed as follows : Department Breast and Cervical Cancer Control Program Orange County Health Deparment P. O. Box 8181 Hillsborough, NC 27278 Primary Care Physicians Name and address as indicated by the patient or by the Deparment In witness whereof, the Contractor and the Department have executed this agreement in duplicate originals, one of which is retained by each of the parties. 14 " J ;6( _2,l it Daniel B. Reimer, Health Director Ric I. Suberman, MD Orange County Health Department Chapel Hill Radiology, PA 110 S. Estes Drive Chapel Hill, NC 27514 #1 OP MammCont Page 3 of 4 ORANGE COUNTY FINANCE DIRECTOR "This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. cif Orange County Finance Director 1 7-G13 Date 0 !/ Cha 'r Orange County Boar." .L Commissioners (O /7/ / Date Page 4 of 4 STATE OF NORTH CAROLINA ORANGE COUNTY COLPOSCOPY SERVICE CONTRACT FOR THE ORANGE COUNTY HEALTH DEPARTMENT BREAST AND CERVICAL CANCER CONTROL PROGRAM Whereas the Centers for Disease Control has awarded funds to the North Carolina Department of Environment, Health and Natural Resources for the purpose of early detection of breast and cervical cancer for low-income women in the state, and Whereas the Department of Environment, Health and Natural Resources has awarded funds to the Orange County Health Department to assure the provision of services on the local level through the implementation of a Breast and Cervical Cancer Control Program (BCCCP) , and Whereas it is necessary for Orange County Health Department to contract for the provision of colposcopic services . Whereas the Centers for Disease Control has mandated certain standardized requirements, Now, therefore, the Orange County Health Department and local provider/contractor, as specified below, agree as follows : This agreement, entered into on ec 7 rc}53 by and between the Orange County Health Department, hereinafter called the "Department, " and the Hillsborough Family Practice Associates, PA hereinafter called the "Contractor, " shall commence on and shall be renewable annually. This agreemarttll be for the purpose of providing colposcopic services to clients referred to the Contractor by the Department under the following conditions . I. The Contractor agrees to: A. Provide colposcopy at the cost of $175 . 00 per patient. This cost is inclusive of all fees and charges for the colposcopy. -- B. Provide colposcopy and biopsy when indicated at a cost of $225 . 00 per patient. This cost is inclusive of all fees and charges for the colposcopy and biopsy. C. The Contractor shall report the results of the colposcopic evaluation and cervical biopsy to the Department with recommendations regarding the need for further care based on the diagnostic results . D. For cervical biopsies that show "Low-Grade SIL, " "High- Grade SIL, " "Squamous Cell Carcinoma, " "Adenocarcinoma, " or other malignant neoplasms, the Contractor shall notify the patient' s primary care provider and the Department of the results by phone or fax no later than one week after receiving the specimen report and shall send the written report by mail no later than two weeks after receipt of the specimen report. Page 1 of 4 E. The Contractor agrees to see the patients referred by the Department for colposcopy no later than three weeks after receipt of referral. F. The Contractor agrees to utilize a laboratory (for interpretation of cervical biopsies) that is licensed in North Carolina and that is in compliance with the rules for cytopathology services in the Clinicial Laboratory Improvement Amendments of 1988 (CLIA ' 88 ) . The laboratory will provide documentation of compliance with CLIA ' 88 by submitting to the Contractor its "Letter of Attestation. " - G. The Contractor shall have professioial liability insurance of no less than $1,000, 000 liability limit and shall provide proof of such coverage to the Department prior to contract commencement. H. The Contractor shall bill directly the designated payment source of clients referred through the Breast and Cervical Cancer Control Program (BCCCP) . BCCCP is the designated payment source of last resort after Medicaid, Medicare, and private insurance. I. The Contractor is prohibited from billing clients for any additional charges for the performance of colposcopy service. II . The Department agrees to: A. Pay the Contractor $175 . 00 for colposcopy and $225 . 00 for colposcopy and biopsy for women referred by the Department who have the Department ' s Breast and Cervical Cancer Control Program as their designated source of payment. III. Termination This agreement between the Department and the Contractor for the provision of colposcopy services to clients referred by the Department may be terminated by either party with 60 days written notice, except in the case of breach of contract, in which case, termination can be immediate. IV. Notice Any notice required by this agreement will be complete upon being deposited in a depository of the US Postal Service with 1st class postage addressed as follows: Department Breast and Cervical Cancer Control Program Orange County Health Department g Y P P. 0. Box 8181 Hillsborough, NC 27278 Page 2 of 4 Primary Care Physician Name and address as indicated by the patient or by the Department In witness whereof, the Contractor and the Department have executed this agreement in duplicate originals, _one of which is retained by each of the parties. Daniel B. Reimer, Health Director Contractor ' Orange County Health Department Hillsborough Family Practice Associates, PA 101 East Corbin Street Hillsborough, NC 27278 #1 OP ColpCont Page 3 of 4 ORANGE COUNTY FINANCE DIRECTOR "This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. _Orange County Finance Director -///'O/q3 - Date r C air Orange County Bo. ."d f Commissioners 7/761/ Date • • 1 Page 4 of 4 111 Durham County Hospital Corporation Durham Regional Hospital 3643 N.ROXBORO ROAD DURHAM,NORTH CAROLINA 27704-2763 919 470-4000 November 4 , 1993 Phillip Singer, -M.D. - Hillsborough Family Practice 101 East Corbin Street Hillsborough, NC 27278 • Dear Phil : I received a telephone call from Robin in your office telling me that a letter of attestation was needed for you to utilize our services for some work you are doing with the health department . The laboratory at Durham Regional Hospital is accredited by the College of American Pathologists, is licensed in the State of North Carolina and has the appropriate CLIA certification. Should documentation of any of this be needed, I will be happy to furnish it . Many thanks for your continuing support . Sincerely, DURHAM REGIONAL HOSPITAL LABORATORIES _.._ John T. Daly, M.D. Director of Laboratories JTD/dmp i3 EMERGENCY MEDICAL TRANSPORTATION SERVICES•HOME TREATMENT AND LIFE CARE•LINCOLN COMMUNITY HEALTH CENTER•OAKLEIGH•WATTS SCHOOL OF NURSING PAUETWD • The term "totally disabled"shall mean that the Insured is permanently, wholly and continuously disabled and prevented from performing any and every duty pertaining to his profession and is under the regular care and attendance of a legally qualified physician other than himself H If,at any time after reaching age 65,and having been continuously insured by the Company on a • claims-made basis for the previous 10 years,the Insured elects to retire from his profession,the Company will offer the"extension contract"described above,and will waive any and all premium charges normally associated with such"extension." I After being continuously insured by the Company on a claims-made basis for 20 years,the Insured will be eligible to receive,at no premium charge,an'extension contract"forhispast2D years of claims-made coverage. J In arty event, the limits of coverage offered in G,H and I above may not exceed the lowest limits purchased by the Insured during the five policy years immediately preceding disability or retirement. Upon the following conditions., - 1 The Insured shall notify the Company,at its General Offices,Fort Wayne,Indiana,or its agent,as soon as possible,of .any threatened claim, with full h.:formation relative to the services rendered;and in event such claim is filed in court shall immediately forward any and all summons or process served together with the originator a copy of any and all other papers relating to said claim. 2 The Insured shall not(a)make any bold harmless agreements or contract any expense nor voluntarily assume any liability in any situation nor(b)make or contract any settlement of a claim hereunder,except at his own cost and responsibility,without the widtten authorization of the Company.The Insured shall at all times fully cooperate with the Company in any claim hereunder and shall attend and assist in the preparation and trial of any such claim. 3 The Insured shall be authorized topracttce its profession under the laws of the State or States in which it operates. 4 Other insurance—The insurance afforded by Ibis policy is primary insurance,except when stated to apply in excess of or contingent upon the absence of other insurance.When this insurance is primary and the Insured bas other insurance which is stated to be applicable o a ca to the loss on an excess or contingent basis,the amount of the Company's liability under this policy shall not be reduced by the existence of such other insurance. When both this insurance and other insurance apply to the loss on the same basis,whether primary,excess or contingent,the Company shall not be liable under this policy for a greater proportion of such loss than the applicable limit of liability under this policy for such loss bears to the total applicable limit of liability of all valid and collectible insurance against such lass. 5 No action shall be maintained against the Company to recover a loss covered by Ibis policy unless brought after the amount of such Tars shall have been fixed either by a final judgmont against the Insured by the court of last resort after trial of the issue or by agreement between the parties with the written consent of the Company and unless brought within two years and one day after such judgment or written agreement,except that,if such period is in conflict with the statutes of the state wherein this policy is issued,it is hereby amended to conform with such statutes,Any person or his legal representative who has secured such judgment or written agreement shall thereafter be entitled to recover under the terms of this policy in the same manner and to the same extent as the Insured.Nothing contained in this policy shall give any person or organisntitm any right to join the Company as a codefendant in any action against the Insured to determine the Insured's liability.Bankruptcy or insolvency of the Insured shall not relieve the Company of any of its obligations hereunder, 6 The interest of the Insured under this policy shall not be assignable to any other person I 7 This policy may be cancelled by the Insured by mailing to the Company or any of its authorized representatives,written notice,stating when thereafter the cancellation shall be effective.This policy may be cancelled by the Company by mailing postage prepaid, to the Insured at the last address on record with tbo Company written notice stating when,not less than 30 days thereafter such cancellation shall bo effective.If the Insured cancels,earned premium shall be computed in accordance with the standard short rate tables and procedure.If the Company cancels, earned premium shall be computed pro rota.Premium adjustments shall be made within a reasonable period of time after cancellation,but payment of or tender of such unearned . premium shall not be a condition of cancellation 8 By acceptance of this policy the Insured agrees that this policy embodies all agreements existing between himself and the 1;;' Company or any of its agents relating to Ibis insurance. 4 9 The following space is intended for waivers exceptions and endorsements.If any, they shall become part of Ibis policy. 125 320 390 526 603 609 Insured's Profession; MEDICINE Retroactive Date: 02/03/89 The Insured: Policy No. 573070 JANE SATTER MD The Premium $ 1817 101 EAST CORBIN ST. TOTAL 1817 HILLSBOROUGH, NC 27278 ' Per Claim Filed S 1,000,000 Annual'Aggregate s 1,000,000 The term of this policy shall begin end end at 12:01 a.m.,standard time,at the place whore the Insured resides MO. DAY YEAR MO. DAY YEAR and be from 02 03 94 to 02 03 95 In ZglittraS. ate.., The Medical Pro- tective Company has caused this policy to be signed try .... „/„...r.,..esfr,&.....________._ [ its President and its Secretary and countersigned by its duly authorized representative. PRESIDENT ‘64."----,,■C". •,,, ,,CLZ&A. COUNTERSIGNED SECRETARY CMI-10-86 IN THE EVENT OF CMM.THREATENED OR FILED, . p IMMEDIATELY ND,PY THE MEDICAL PROTEOTIVE COMPANY,Fair WAYNE,INDIANA I; F` FOR SERVICE CALL- MR. ROBER,140t,AL'LtA13h X,LICY @ 919-467-8370 i. Continuous sarvice to the professional since 1099 R N PAGE TWO The term "totally disabled"shall mean that the Insured is permanently, wholly and continuously disabled and prevented from performing any and every duty pertaining to his profession and is under the regular care and attendance of a legally qualified physician other than himself. H If at any time after reaching age 65,and having been continuously insured by the Company on a claims-made basis for the previous 10 years,the Insured elects to retire from his profession,the Company will offer the"extension contract"described above,and will waive any and all premium charges normally associated with such"extension." I After being continuously insured by the Company on a claims-made basis for 20 years,the Insured will be eligible to receive,at no premium charge,an"extension contract"for his past 20 years of claims-made coverage. J In any event, the limits of coverage offered in G,H and I above may not exceed the lowest limits -purchased by the Insured during the five policy years immediately preceding disability or retirement. Upon the following conditions: - I The Insured shall notify the Company,at its General Offices,Fort Wayne,Indiana,or its agent,as soon as possible,of any threatened claim,with full information relative to the services rendered;and its event such claim is filed in court shall immediately forward any and all summons or process served together with the original or a copy of any and all other papers relating _ to said claim. 2 The Insured shall not(a)make any bold harmless agreements or contract any expense nor voluntarily assume any liability in any situation nor(h)make or contract any settlement of a claim hereunder,except at his own cost and responsibility,without the written authorization of the Company.The Insured shall at all times fully cooperate with the Company in any claim hereunder and shall attend and assist in the preparation and trial of any such claim. 3 The Insured shall be authorized topractico its profession under tbo Taws of the State or States in which it operates.' 4 Other insurance—The insurance afforded by this policy is primary insurance,except when stated to apply in excess of or contingent upon the absence of other insurance.When this insurance is primary and the Insured has other insurance which is stated to be applicable to the loss on an excess or contingent basis,the amount of the Company's liability under this policy shall not be reduced by the existence of such other hisurance. When both this insurance and other insurance apply to the loss on the same basis,whether primary,excess or contingent,the Company shall not be liable under this policy for a greater proportion of such loss than the applicable limit of liability under this policy for such loss bears to the total applicable limit of liability of all valid and collectible insurance against such lats. 5 No action shall be maintained against the Company to recover a loss covered by this policy unless brought after the amount of of such loss shall have been fixed either by a final judgment against the Insured by the court of resort after trial of the issue or by agreement between the parties with the written consent of the Company and unless brought within two years and one day after such judgment or written agreement except that,if such period is in conflict with the statutes of the state wherein this policy is issued,it is hereby amended to conform with such statutes.Any person or his legal representative who has secured such judgment or written agreement shall thereafter be entitled to recover under the terms of this policy in the same manner and to the same extent as the Insured.Nothing contained in this policy shall give any person or organization any right to join the Company as a codefendant in any action against the Insured to determine the Insured's liability.Bankruptcy or insolvency of lbe Insured shall not relieve the . Company of any of its obligations hereunder. 6 The interest of tbe'nsured under this policy shall not be assignable to any other person. 7 This policy may be cancelled by the Insured by mailing to the Company or any of its authorized representatives written notice,stating when thereafter the cancellation shall be effective.This policy may be cancelled by the Company by mailing postage prepaid, to the Insured at the last address on record with the Company written notice stating when,not loss than 30 days thereafter,such cancellation shall be effective.If the Insured cancels,earned premium shall be computed in accordance with the standard short rate tables and procedure.If the Company cancels, earned premium shall be computed pro rata.Premium adjustments shall be made within a reasonable period of time after cancellation,but payment of or tender of such unearned premium shall not he a condition of cancellation. 8 By acceptance of this policy the Insured agrees that this policy embodies all agreements existing between himself and the Company or any of its agents relating to this insurance. 9 The following space is intended for waivers,exceptions and endorsements.If any,they shall become part of this policy. 125 320 390 526 532 603 609 Insured's Profession: MEDICINE Retroactive Date: 08/14/85 The insured: ■ Policy No. 582850 DANIEL DAVID CRUMMETT MD 1` The Premium S 1817 101 EAST CORBIN ST. TOTAL 1817 HILLSBOROUGH, NC 27278 Per Claim Filed $ 1,000,000 Annual Aggregate S 1,000,000 .,, The term of this policy shell begin end end at 12:01 a.m.,standard lime,at the place whore the Insured resides Mo. DAY YEAR MO. DAY YEAR and be from 12 31 93 to -12 31 94 DoT Company =tarot,p Theo be sin Pro- /..... 71Y✓�. tective Company bas caused this policy to be signed by its President and its Secretary and countersigned by its duly authorized representative. PRESIDENT COUNTERSIGNED SECRETARY CM1•lwSl IN THE EVENT OF CLAIM.THREATENED OR FILED. IMMEDIATELY NOTIFY THE MEDICAL PROTECTIVE COMPANY.FORT WAYNE.INDIANA FOR SERVICE CALL: J. MICHAK,L,.4,Thiggp.,�Y @ 9,19-467-8370 . i ..__.,_.._..__. ..-.,ae....,u.as,n laI since 1099 RI 1,4.1.MO The term "totally disabled"shall mean that the Insured is permanently, wholly and continuously disabled and prevented from performing any and every duty pertaining to his profession and is under the regular care and attendance of a legally qualified physician other than himself. . H If,at any time after reaching age 65,and having been continuously insured by the Company on a claims-made basis for the previous 10 years,the Insured elects to retire from his profession,the Company will offer the"extension contract"described above, and will waive any and all premium charges normally associated with such"extension." I After being continuously insured by the Company on a claims-made basis for 20 years,the Insured will be eligible to receive,at no premium charge,an"extension contract"forhis past 20 years of claims-made coverage. - J In any event,the limits of coverage offered in G,H and I above may not exceed the lowest limits purchased by the Insured during the five policy years immediately preceding disability or retirement. Upon the following conditions: I The Insured shall notify the Company,at its General Offices,Fort Wayne,Indiana,or its agent,as soon as passible,of any threatened claim, with full information relative to the services rendered;and in event such claim is filed in court shall immediately forward any and all summons or process served together with the original or a copy of any and all other papers relating to said claim. 2 The Insured shall not(a)make any bold harmless agreements or contract any expense nor voluntarily assume any liability in any situation nor(b)make or contract any settlement of a claim hereunder,except at bit own cost and responsibility,without the written authorisation of the Company.The Insured shall at all times fully cooperate with the Company in any claim hereunder and shall attend and assist in tbepreparation and trial of any such claim. 3 The Insured shall be authorized to practice its profession under the laws of the State or States in which it operates. 4 Other insurance—The insurance afforded by this policy is primary insurance,except when slated to apply in excess of or contingent upon the absence of other insurance.When this insurance is primary and the Insured has other insurance which is stated to be applicable to the loss on an excess or contingent basis the amount of the Company's liability under this policy shall not be reduced by the existence of such other insurance. When both this insurance and other insurance apply to the lass on the same basis,whether primary,excess or contingent,the Company shall not be liable under this policy for a greater proportion of such lass than the applicable limit of liability under this policy for such loss bears to the total applicable limit of liability of all valid and collectible insurance against such loss. 5 No action shall be maintained against the Company to recover a loss covered by this policy unless brought after the amount of such loss shall have hem:fixed either by a final Judgment against the Insured by the court of last resort after trial of the issue or by agreement between the parties with the written consent of tba Company and unless brought within two years and one day after such judgment or written agreement,except that,if such period is in conflict with the statutes of the state wherein this policy is . issued,it is hereby amended to conform with such statutes.Any person or his legal representative who has secured such judgment or written agreement shall thereafter be entitled to recover under the terms of this policy in the same manner and to the same extent as the Insured,Nothing contained in this policy shall give any person or organization any right to join the Company as a codefendant in any action against the Insured to determine the Insured's liability.Bankruptcy or insolvency of the Insured shall not relieve the Company of any of its obligations hereunder. 6 The interest of the Insured under this policy shall not be assignable to any other person. 7 This policy may be cancelled by the Insured by mailing to the Company or any of its authorized representatives,written notice,stating when thereafter the cancellation shall be effective.This policy may be cancelled by the Company by mailing,postage id prepaid, to the Insured at the last address on record with the Company written notice stating when, not less than 30 days thereafter,such cancellation shall be effective.If the Insured cancels earned premium shall be computed in accordance with the standard short rate tables and procedure.If the Company cancels, earned premium shall be computed pro rata.Premium j' adjustments shall be made within a reasonable period of time after cancellation,but payment of or tender of such unearned ! premium shall not be a condition of cancellation. 8 By acceptance of this policy the Insured agrees that this policy embodies all agreements existing between himself and the Company or any of its agents relating to this insurance. 9 The following space is intended for waivers,exceptions and endorsements.If any,they shall bacone part of this policy. i; 125 320 390 526 532 603 609 i' Insured's Profession: MEDICINE Retroactive Date: 10/07/77 The Insured: Policy No. 582849 F PHILIP G SINGER MD The Premiums 1817 101 EAST CORBIN ST. TOTAL 1817 HILLSBOROUGH, NC 27278 Per Claim Filed s 1,000,000 Annual Aggregate S 1,000,000 Thu term of this policyshall begin and end at 12;01 a.m..standard time,at the place where the Insured resides i'' MO. DAY YEAR MO, DAY YEAR and befrom 12 31 93 to 12 31 94 a11( co.itttt$5 Zintreot, The Medical Pro- tective Company bas caused this policy to be signed by , its President and its Secretary and countersigned by its duly authorized representative. PRESIDENT''� /� .��. of z. ��r�4 COUNTERSISNED SECRETARY CMI.10-81 IN THE EVENT OF CLAIM.THREATENED DR FILED. IMMEDIATELY NOTIFY THE MEDICAL PROTECTNE COMPANY.FORT WAYNE.INDIANA t. FOR SERVICE CALL: J, MI CHAglEe�o ,D113PDIIOY @ 919-467-8370 �` Continuous service to the professional since 1889 RN C G