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DocuSign Envelope ID:23AA9521-5A8A-4D16-9A81-7143D7D4F7C3 <br /> Endorsement 'XA; <br /> North Carolina Amendatory Endorsement ZURICH <br /> Certificate No. Eff.Date of Cert. Exp.Date of Cert. Eff.Date of End. Add'll Prem. Return Prem. <br /> VETPR0127933 01/01/2019 1 01/01/2020 $287.00 $0.00 <br /> Named Certificate Holder and Mailing Address: Producer: <br /> HUB International Midwest Limited <br /> Chelsea Dawn Landon,DVM 55 East Jackson Boulevard <br /> 3710 Cole Mill Rd Chicago,IL 60604-4187 <br /> Durham,NC 27712-2902 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> This endorsement modifies insurance provided under the: <br /> Veterinary Professional Liability Insurance Policy <br /> It is agreed that Section IV--CONDITIONS,Paragraph❑is deleted in its entirety and replaced with the following: <br /> 1. CANCELLATION <br /> a. This policy may be canceled by the Named Certificate Holder by surrender of the policy to the Company or by mailing <br /> written notice to (lie Company stating when such cancellation shall take effect. If canceled by the Named Certificate <br /> Holder,the Company shall retain the customary short-rate proportion of the premium. In no event may the requested date of <br /> cancellation be greater than ten(10)days prior to the date the request is received by the Company. <br /> b. If this policy has been in effect less than sixty (60) days, the Company may cancel this policy for any reason by mailing <br /> written notice by certified mail to the Named Certificate Holder at the address shown in the Certificate of Insurance,and <br /> mailing to the producer of record, if any. Such cancellation shall be no fewer than fifteen(15)days from the date the notice <br /> is mailed. Such notice shall state the reason for cancellation and if applicable be accompanied by a refund of unearned <br /> premium,except a premium that has been financed. <br /> c. If this policy is in effect sixty(60)days or more,the Company may cancel this policy for the following reasons: <br /> (1) Nonpayment of premium in accordance with the policy terms; <br /> (2) An act or omission by the Named Certificate Holder or his representative that constitutes material misrepresentation <br /> or nondisclosure of a material fact in obtaining the policy, continuing the policy, or presenting a Claim under the <br /> policy; <br /> (3) Increase hazard or material change in the risk assumed that could not have been reasonably contemplated by the parties <br /> at the time of assumption of the risk; 1 <br /> (4) Substantial breach of contractual duties,conditions,or warranties that materially affects the insurability of the risk; <br /> (5) A fraudulent act against the company by the Named Certificate Holder or his representative that materially affects the <br /> insurability of the risk; <br /> (6) Willful failure by the Named Certificate Holder or his representative to institute reasonable loss control measures that <br /> materially affect the insurability of the risk after written notice by the company; <br /> (7) Loss of facultative reinsurance,or loss of or substantial changes in applicable reinsurance as providcd in O.S.58-41-30; <br /> (8) Conviction of the Insured of a crime arising out of acts that materially affect the insurability of the risk;or d <br /> (9) A determination by the commissioner that the continuation of the policy would place the Company in violation of the & <br /> laws of the state of North Carolina. <br /> If the Company cancels subject to c(1) through c(9) above, the Company will mail by certified mail to the Named <br /> Certificate Holder at the address shown in the Certificate of Insurance,and mail to the producer of record,if any. <br /> Written notice of cancellation shall take effect fifteen(15)days from the date of mailing for the reasons set fortis in c(1) <br /> through c(9)above. <br /> Any written notice of cancellation subject to c(1)through c(9) will state the reason for such cancellation and will be <br /> accompanied by a refund of unearned premium,except a premium that has been financed. <br /> d. If notice is mailed,proof of mailing will be sufficient proof of notice. <br /> e. The Company shall refund the unearned premium computed at customary short rates if the policy is terminated by <br /> the Named Certificate Holder. Under any other circumstances the refund shall be computed pro rata. <br /> U-VPL-128-A-NC(09/04) <br /> Page I of 2 <br />