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DocuSign Envelope ID:26FFAC14-685F-4DB8-985B-76lD8D052080 <br /> AVMA I PL.IT" 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- Z U R I G H <br /> ITEM 1:Insured by the stock company below and hereinafter called the Company <br /> Zurich American Insurance Company tl-VPL-101-A-CW(07104) <br /> ITEM 2:Named Certificate Holder,member number,rating code and address Master Policy Number: Certificate Number. ' <br /> EOL.5241302-14 VETPR0085334 <br /> Bethany Walters,DVM FOR INFORMATION OR TO FILE A CLAIM <br /> 6325 Mimosa Dr. PLEASE CALL-(800)228-7548 <br /> Chapel.Hill,NC 27514 ITEM 3:Policy Period <br /> From: 01/01/2019 <br /> To: 01/01/2020 <br /> 12:U 1 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. Rating Code Each claim $ 1,000,000 <br /> Bethany Walters 261785 [IV]Small Animal Exclusive Aggregate $3,000,000 = <br /> ITEM 5:Premium and coverage summary ITEM 6:Dorms Attached at Issuance: <br /> Primary Professional Liability $248.00 U-VPI:100-A CW(07104);U-VPL-103-A CW(07/04);i]-GU-1191-A CW(03/15); <br /> Veterinary License Defense $109.00 U-VPL-128-A NC(10/04);U-VPLr155-A NC(10/04);U-VPL-102-B CW(06/11); <br /> U-GU-319-F(01/09);U-GU-1194-A CW(08/15) <br /> ITEM 7:Schedule of Plan Numbers and location(s)for Professional EXterrSiOn <br /> TOTAL DUE: 5357 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 Plalr <br /> ITEM S.Veterinary Professional Liability Regulatory Action License Defense <br /> Coverage endorsement[if purchased): Veterinary <br /> 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: $50,000 acceptance of this policy the Named Certificate Holder agrees that the statements in <br /> the certificale 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 /> s of its representatives relating to this insurance. <br /> Notice to(lie Company: Zurich American insurance Company <br /> P.0-Box 969041 <br /> Neil R.Hughes,President Schaumburg,IT.60 1 96-804 1 <br /> HUB International Midwest Limited <br />