Professional Liability Insurance Policy This is a claims-made Policy. Please review you Policy carefully. The Policy is limited to liability for only those claims that are first made against the insured during the policy period Interstate Insurance Group Chicago Insurance Company Executive Offices: 55 E. Monroe St. Chicago, IL 60603 Policy Number: LWB-3016091-0 Named Insured & Address: Scott B. Ugel 155 North Main St. New City, NY 10956 And those individuals listed in the insured supplement Producer Name Bertholon Rowland Corp. Policy Period 5/1/99 to 5/1/00 Insured is: Individual Limit of Liability: $1,000,000 each claim $1,000,000 aggregate (A separate limit of liability applies to claim expenses) Deductible $1,000 per claim Premium $3,536.00 Claim 81400 No. of Lawyers 2 Forms attached at Issue: POE-2182 (04/97) New York Mandatory POE-2247 (12/1/96) Claim Expenses in addition to llimits POJ-2018 (01/95) Lawyers Claims-Made Policy Jacket Bertholon-Rowland Countersigned at: New York, NY Insurance Brokers Issue Date 6/17/99 100 Broadway New York, NY 10005 250