2016-343-E Animal Svc - Claudia H. Sheppard, DVM for veterinary services

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DocuSign Envelope ID:2A1EB275-A6CB-484A-ABD4-C1F2E7C54E2B Endorsement 9 North Carolina Amendatory Endorsement ZURICH Certificate No. Eff.Date of Cert. Exp.Date of Cert. Eff.Date of End. Add'!Prem. Return Prem. VETPRO008742 01/01/2016 01/01/2017 $307.00 $0.00 Named Certificate Holder and Mailing Address: Producer: HUB International Midwest Limited Claudia H. Sheppard,DVM 55 East Jackson Boulevard 101 Autumn Lane Chicago,IL 60604-4187 Chapel Hill,NC 27516-1101 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Veterinary Professional Liability Insurance Policy It is agreed that Section IV—CONDITIONS,Paragraph D is deleted in its entirety and replaced with the following: 1. CANCELLATION a. This policy may be canceled by the Named Certificate Holder by surrender of the policy to the Company or by mailing written notice to the Company stating when such cancellation shall take effect. If canceled by the Named Certificate Holder,the Company shall retain the customary short-rate proportion of the premium. In no event may the requested date of cancellation be greater than ten(10) days prior to the date the request is received by the Company. b. If this policy has been in effect less than sixty (60) days, the Company may cancel this policy for any reason by mailing written notice by certified mail to the Named Certificate Holder at the address shown in the Certificate of Insurance, and mailing to the producer of record, if any. Such cancellation shall be no fewer than fifteen(15) days from the date the notice is mailed. Such notice shall state the reason for cancellation and if applicable be accompanied by a refund of unearned premium,except a premium that has been financed. c. If this policy is in effect sixty(60) days or more,the Company may cancel this policy for the following reasons: (1) Nonpayment of premium in accordance with the policy terms; (2) An act or omission by the Named Certificate Holder or his representative that constitutes material misrepresentation or nondisclosure of a material fact in obtaining the policy, continuing the policy, or presenting a Claim under the policy; (3) Increase hazard or material change in the risk assumed that could not have been reasonably contemplated by the parties at the time of assumption of the risk; (4) Substantial breach of contractual duties,conditions,or warranties that materially affects the insurability of the risk; (5) A fraudulent act against the company by the Named Certificate Holder or his representative that materially affects the insurability of the risk; (6) Willful failure by the Named Certificate Holder or his representative to institute reasonable loss control measures that materially affect the insurability of the risk after written notice by the company; (7) Loss of facultative reinsurance,or loss of or substantial changes in applicable reinsurance as provided in G.S.58-41-30; (8) Conviction of the Insured of a crime arising out of acts that materially affect the insurability of the risk;or (9) A determination by the commissioner that the continuation of the policy would place the Company in violation of the laws of the state of North Carolina. If the Company cancels subject to c(1) through c(9) above, the Company will mail by certified mail to the Named Certificate Holder at the address shown in the Certificate of Insurance,and mail to the producer of record,if any. Written notice of cancellation shall take effect fifteen(15) days from the date of mailing for the reasons set forth in c(1) through c(9)above. Any written notice of cancellation subject to c(1) through c(9) will state the reason for such cancellation and will be accompanied by a refund of unearned premium,except a premium that has been financed. d. If notice is mailed,proof of mailing will be sufficient proof of notice. e. The Company shall refund the unearned premium computed at customary short rates if the policy is terminated by the Named Certificate Holder. Under any other circumstances the refund shall be computed pro rata. U-VPL-128-A-NC(09/04) Page 1 of 2