SUNRISE MULTISPECIALISTS MEDICAL CENTER (2)

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COOPERATIVE OF AMERICAN PHYSICIANS CERTIFICATE OF COVERAGE AND CLAIMS HISTORY Coverage through December 31, 2021 Member: Mary-AnnNuesse, DO Address: 867 S Tustin Ave, Orange, CA 92866 This certificate confirms that, effective on the coverage date below, the above -named physician is a member of the Cooperative of American Physicians, Inc. (CAP) and a participant in the Mutual Protection Trust (MPT). MPT is an unincorporated interindemnity, arrangement organized under California Insurance Code section 1280.7. This certificate confers no rights upon the member and does not amend, extend or alter the coverage afforded under the terms, conditions and exclusions of the MPT Agreement. Membership Number 13925 Medical Specialty Family Medicine, With Minor Surgery Coverage Date April 1, 2004 Retroactive Coverage Date February 1, 2002 Subspecialty Coverage (Claims made and paid) Current Limits of Liability $1,000,000 for all Claims based Medical Professional Liability Coverage upon an Occurrence $3,000,000 each calendar year aggregate The member must remain a Member in good standing or arrange for Tail Coverage for any open or potential Claim that may arise during the Coverage Period. Neither CAP nor MPT undertake any obligation to advise any party, other than die named member, of any changes to or termination of this coverage. Claims History No Claims Reported The Claims history listed above includes all Claims that are currently open and those that were closed within the last five years. The Claims history does not include payments for emergency or other remedial expenses that may have been made to patients through MPT's Patient Assistance Services program. Cooperative of American Physicians, Inc. December 30, 2020 Alfred De Leon Date Vice President, Membership Services Mutual Protection Trust .e'�^=._ litrkMarugnnenEDltiafon 8�',�,5fr�vievm&Arvaov®Br. ® Risk Management Analyst