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TRAVELERSJ�
<br />ONE TOWER SQUARE
<br />HARTFORD CT 06183
<br />Named Insured: VGA Consultants, Inc.
<br />Policy Number: UBIR294848
<br />WORKERS COMPENSATION
<br />AND
<br />EMPLOYERS LIABILITY POLICY
<br />ENDORSEMENT WC 99 03 76 ( A)
<br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
<br />ENDORSEMENT - CALIFORNIA
<br />(BLANKET WAIVER)
<br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
<br />enforce our right against the person or organization named in the Schedule.
<br />The additional premium for this endorsement shall be 2.00 %of the California workers' compensation pre-
<br />mium.
<br />Schedule
<br />Person or Organization Job Description
<br />ANY PERSON OR ORGANIZATION FOR Are Paz Mitten CORCSaCt
<br />WHICH THE INSURED HAS AGREED
<br />BY WRITTEN CONTRACT EXECUTED
<br />PRIOR TO LOSS TO FURNISH THIS
<br />WAIVER.
<br />This endorsement changes the policy to which If is attached and is effective on the date issued unless otherwise
<br />stated.
<br />(The information below is required only when this endorsement is Issued subsequent to preparation of
<br />the policy.)
<br />REVIEWED & APPROVED
<br />By Risk MANAGEMENT DIVISION
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<br />VKANI R. Vi REALR. VI REAL
<br />�1 VCACONS-01
<br />MCGRAW
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<br />CERTIFICATE OF LIABILITY INSURANCE
<br />a,E1NXwmm
<br />]LDER.0
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND MOLDER. THIS
<br />UPON THEAFFORDED
<br />OE
<br />CERTIFICATE DOES NOT 00. EXTEND R ALTER THE C
<br />AMEND, E%TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />B
<br />CERTIFICATE INSURANCE DOESNOT C
<br />BELOW. THIS CEORPRODU OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURfR(S), AUTHORIZED
<br />ZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE MOLDER,
<br />IMPORTANT: If the cetifcate, udder Is an AUOfItI INSURED, the policylles) must Have ADDITIONAL INSURED pravli loin or be andoraad
<br />If SUBROGATION Is WANED, aubleCt to the tarms and condNlone of the POLICY, cenaln Policies rosy reaulre an endorsement A statement on
<br />Nis eamfesta 6. no Plantain tab to he certificate holder in lieu ei such endorearo a
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<br />IDA Insurance services
<br />4370 La JOlIe Village Drive
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<br />San Diego, CA 92122
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<br />(See Deal of Operations for Full Named Insured)
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<br />1845 W, Orangewood Ave, Sulh 299
<br />Orange, CA 92868
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<br />COVERAGES GER11FICATENUMBER REVISION NUMBER'
<br />THIS E TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUEDTO THE INSURED NAMEDABOVE FOR THE POLICY FRAUD
<br />INDICATED NOTWMSTANDING ANY REQUIREMENT. TERM OR CONDITION OF My CONTRACT OR OTHER DOCUMENT MATH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMnS SHIXNN MY HAVE BEEN REDUCED BY PAID CMM3.
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<br />Named Inwntl includes! Has VCA Structural; VCA C.sLlHn%:Ynr Dorpe dlwu As..lama, Ine.W`N
<br />TM Coda Group, Inc.; cut VCA Green; do. VCA Code; dG VCA Code Group.
<br />Umbrella policy is afollawinm to md.14ing Gnenl LiabilXylAuto LIabllindEmployss LiaNIIN
<br />Re: Conaaq StMnn9, Plan CMcla, and SustaloselllN Sonless
<br />Clry Of Sama Are, offli sent., empleyaes, and vi.lian er... Acidulated Inaande with rainier to General antl Aum Llablily par 1Xe aHacM1ed
<br />SEE ATTACHED ACORD 101
<br />CERTIFICATE HOWER
<br />R EVIEWEUOIAFYIt V LLbANCELLATION
<br />By RI31f ANAGEMBVT I1/ISlpfi
<br />fiNgILO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />7
<br />THE EXPIRATION GATE THEREOF, NOTICE WILL BE OENVERED m
<br />ACCOXDNICE WRX THE POLICY PROVISIONS.
<br />City or Suds Ana
<br />Ri y.f Same Ana olmmn
<br />20 CIVIF Center Place
<br />wrwReeonvneaExx^rev
<br />q / J'nese
<br />R2AN I R. VILLAREA
<br />So [II CA R2702
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<br />LJ IC'
<br />ACORD 25(2018/03)
<br />91980-2015 ACORO CORPORATION. All rlOhm reserved.
<br />The ACTED name and Ingo am registered marba of ACORD
<br />
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