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DocuSign Envelope ID:4990EA2C-8AA3-4013-9AC4-2lD01E1559BF <br /> AV M A I P L I Tc Veterinary Professional Liability <br /> Protecting you through it all Insurance Policy <br /> Certificate of Insurance This policy provides occurrence coverage.Plcase review the policy carefully. Z U R I C H <br /> ITEM 1:Insured by the stock company below and hereinafter called the Cam pany <br /> Zurich American Insurance Company IJ-VPL-103-A-CW(07M) <br /> ITEM 2:Named Certificate Holder,member number,rating code and address Master Policy Number: Certificate Number: <br /> EOL 5241302-14 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: 01/01/2019 <br /> To: 01/01/2020 <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. Ratite 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 $193.00 U-VPL-100-A CW(07/04);U-VPL-103-A CW(07/04);U-GU-I191-A CW(03/15); <br /> Veterinary License Defense S94.00 U-VPL-129-A NC(10/04);U-VPL-155-A NC(10/04);U-VPL-102-B CW(06111); <br /> U-GU-319-F(01/09);U-GU-1194-A CW(08/15) <br /> ITEM 7:Schedule of Plan Numbers and localion(s)for Professional Extension <br /> TOTAL DUE: $287,00 Endorsement(Animal Bailee)/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 Flamed.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 /> or its representatives relating to this insurance. <br /> � 1 <br /> Notice to the Company: "Lunch American Insurance Company <br /> P.O.Box 96804 t <br /> Neil R.Hughes,President Schaumburg,IL 60196-8041 <br /> HUB International Midwest Limited <br />