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DocuSign Envelope ID: E79ED076-5FB2-4A4E-A331-OD857EDC1609 <br /> ,,Cy,V M A I P LM Veterinary Professional Liability <br /> Protecting you through it all Insurance Policy <br /> Certificate of Insurance <br /> This policy provides occurrence coverage.Please review the policy carefully. ZURICH <br /> ITEM I-Insured by the stock company below and hereinafter called the Company <br /> Zurich American Insurance Company 1I-VPL-103-A-CW(07104) <br /> ITEM 2:Named Certificate Holder,member number,species,and address Master Policy Number: Certificate Number: <br /> EOL 5241302-13 VETPR0044232 <br /> Renee M. Carter,DVM FOR INFORMATION OR TO FILE A CLAIM <br /> 2808 Becketts Ridge Drive PLEASE CALL(800)228-7548 <br /> Hillsborough,NC 27278 ITEM 3:Policy Period <br /> From: 01/01/2018 <br /> To: 01/01/2019 <br /> 12:01 am Standard time at the address of the Named Certificate Holder <br /> as stated herein <br /> ITEM 4:Limits of Liability <br /> Member Name Member No. Snecics Type Each claim $100,000 <br /> Renee Carter 246657 [IV]Small Animal Exclusive Aggregate $300,000 <br /> ITEM 5:Premium and coverage summary ITEM 6:Forms Attached at Issuance: <br /> Primary Professional Liability $185.00 U-VPL-100-A CW(07/04);U-VPL-103-A CW(07/04);GU-1191-A-CW(3115);U- <br /> Veterinary License Defense $85.Q0 VPL-128-A NC(10/04);U-VPL-155-A NC(10104);U-VPL-102-B CW(06/11);U- <br /> OU-319-F(01/09);U-GU-1194-A CW(09115) <br /> ITEM 7:Schedule of Plan Numbers and location(s)for Professional Extension <br /> TOTAL DUE: $270.00 Endorsement(Animal Bailec)1 Embryo and Semen Storage(if purchased): <br /> For additional locations,please see the attached page <br /> Location Number/Address Extension Plan Embryo Plan <br /> ITEM 8:Veterinary Professional Liability Regulatory Action License Defense <br /> Coverage endorsement{if purchased): This Certificate of Insurance is issued off the Master Policy held by the American <br /> Veterinary Medical Association(AVMA)Professional liability Insurance Trust,By <br /> Limit: $25,000 acceptance of this policy the Named Certificate Holder agrees that the statements in <br /> the certificate and the application and any attachments hereto are the Named <br /> Authorized Signature Certificate Holder's agreements and representations and that this policy embodies all <br /> agreements existing between the Named Certificate holder&the Company or any <br /> of its representatives relating to this insurance. <br /> Notice to the Company: "Zurich American Insurance Company <br /> P.O.Box 968041 <br /> Neil R Hughes,President Schaumburg,IL 60196-8041 <br /> HUB International Midwest Limited <br />