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DocuSign Envelope ID: F5F7C40B-2B2B-4B38-AF66-907D8AF2244C <br /> 's <br /> E <br /> AV M A P L T �'eterinary Professional Liability <br /> Protecting you through it all Insurance Policy <br /> Certificate of Insurance <br /> This policy provides occurrenee coverage.Please remit/the policy carefully. Z U R I C H t <br /> ITEM 1:Insured b►'the stock company bellow and hereinafter called the Company j <br /> Zurich American Insurance Company' v VP€.-lo3 a-CXV(oW04) � <br /> r <br /> ITEM 2:Named Certificate Holder,member amaber,rating code and address Master Policy Number: Certificate Number: <br /> EaL 5241302-14 VETPROOD8742 } <br /> Claudia H.Sheppard,DVM FOR INFORMATION OR TO FILE A CLAIM <br /> 101 Autimin Lane PLEASE CALL(800)228-7548 <br /> Chapel Hill,NC 27516-1101 ITEM 3.Policy Period j <br /> From: 01/01/2019 <br /> t <br /> To: ❑110112020 <br /> 12:01 ant Standard lime at the address of the Named Certificate Holder ' <br /> as stated herein <br /> a <br /> ITEM 4:Limits of Liability i <br /> Member Name Member No. Ratode Each claim $1.000.000 <br /> Clandia Sheppard 120285 [IV]Small Animal Exclusive Aggregate $3;000,000 <br /> 6 <br /> ITEM 5:Premium and coverage summary ITEM 6:Foams Attached at lasuance: <br /> Primary Professional Liability S248.00 U-VPL-100-A CW(07/04);U-VPL-103-A CW(07104),U-OU-1191-A CW(03115); <br /> Veterinary License Defense $94.00 U-VPL-128-A NC(10/04);U-VPL-1 55-A NC(10104);U-VPL-102-I3 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. 5342 Off Endorsement(Animal Bailee)1 Embryo and Sefnen Storage(if purchased): <br /> For additional locations.please see the attached page <br /> Location Nu mherlAddeess Extension Pian Embryo Plau <br /> i <br /> F <br /> ITEM 8:Veterinary Professional Liability Regulatory Action License Defense This Certificate of Istsurance is issued off the Master Policy held by the American <br /> Coverage endorsement(if purchased): <br /> Veterinasy 14edical Association(AV14fA)Professional Liability Insurance Trust.By <br /> Limit: 925,000 acceptance of this policy the Named Certificate Holder agrees drat 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&file Company or any <br /> of its represenlativea relating to this insurance. <br /> Notice 10 the Company: Zurich American Insuraarce Compalry <br /> P.O.Box 968041 <br /> Neil R.Hughes,President Schaumburg,IL 60196-804I <br /> HUB international Midwest Limited <br />