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Veterinary Professional Liability <br />Insurance Policy <br />Certificate of Insurance <br />This policy provides occurrence coverage. Please review the policy carefully. <br />ITEM 1: Insured by the stock company below and hereinafter called the Company <br />Zurich American Insurance Company U-VPL-103-A-CW (07/04) <br />ITEM 2:Named Certificate Holder, member number, rating code and address Master Policy Number:Certificate Number: <br />EOL 5241302 -15 VETPRO066930 <br />FOR INFORMATION OR TO FILE A CLAIM <br />PLEASE CALL (800) 228-7548 <br /> ITEM 3: Policy Period <br />From:01/01/2020 <br />To:01/01/2021 <br /> 12:01 am Standard time at the address of the Named Certificate Holder <br /> as stated herein <br /> <br />Katherine Eleanor Hamon, DVM <br />5401 Carey Place <br />Durham, NC 27712 <br /> ITEM 4: Limits of Liability <br />Member Name Member No.Rating Code Each claim $ 1,000,000 <br />Katherine Hamon 252865 [IV] Small Animal Exclusive Aggregate $ 3,000,000 <br />ITEM 5:Premium and coverage summary ITEM 6: Forms Attached at Issuance: <br />U-VPL-100-A CW (07/04); U-VPL-103-A CW (07/04); U-GU-1191-A CW (03/15); <br />U-VPL-128-A NC (10/04); U-VPL-155-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 Extension <br />Endorsement (Animal Bailee) / Embryo and Semen Storage (if purchased): <br />For additional locations, please see the attached page <br />Primary Professional Liability <br />Veterinary License Defense <br />TOTAL DUE: <br />$248.00 <br />$120.00 <br />$368.00 <br /> Location Number/Address Extension Plan Embryo Plan <br />ITEM 8:Veterinary Professional Liability Regulatory Action License Defense <br />Coverage endorsement (if purchased): <br />Limit:$ 50,000 <br />Authorized Signature <br />Neil R. Hughes, President <br />HUB International Midwest Limited <br /> 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 /> 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 /> 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 />Schaumburg, IL 60196-8041 <br />DocuSign Envelope ID: 2D437FD3-F8AA-487E-900D-AD3E72792492