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ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID MC DATE(MM/DD/YYYY) <br />coMVE-1 10/24/08 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Veterinary Ins. Services Co . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />CA License #OF64180 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />1400 River Park Drive, #180 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Sacramento CA 95815 <br />Phone :888-762-3143 Fax:916-921-2266 <br />INSURED <br />Community Veterinary Hospital <br />William A Grant II, DVM <br />13200 Euclid Street <br />Garden Grove CA 92843 <br />INSURERS AFFORDING COVERAGE <br />INSURER A: Fireman's Fund Insurance Co. <br />INSURER B. <br />INSURER C. <br />INSURER D <br />INSURER E <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LTR INSR❑ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION —---------------- - <br />DATE MM/DD/YY DATE MM/DD/YY LIMITS <br />GENERAL LIABILITY EACH OCCURRENCE li $ _1 r 000 000 <br />A R X _ - ---- -- <br />_ COMMERCIAL GENERAL LIABILITY 8H4AZC80832474 10/01/08 10/01/09 PREMISES (Ea owurence) $ 100, 000 <br />CLAIMS MADE XJ OCCUR r--- ---------- <br />..___.—_._ _ MED EXP -- <br />NAIC # <br />GEN'L AGGREGATE LIMIT APPLIES PER. <br />X POLICY I^ <br />PRO -LOC <br />AUTOMOBILE LIABILITY <br />A ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />X HIRJED AUTOS <br />X NON -OWNED AUTOS <br />GARAGE LIABILITY <br />ANY AUTO <br />8H4AZC80832474 <br />EXCESS/UMBRELLA LIABILITY <br />A — occuR �I CLAIMS MADE 18H4AZC80832474 <br />DEDUCTIBLE <br />X i RETENTION $ <br />WORKERS COMPENSATION AND <br />A EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />If yesdescribe under <br />SPECIAL PROVISIONS below <br />OTHER <br />8H4WZP80965134 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />The certificate holder is named as additional insured. <br />10 -day notice of cancellation for non-payment. p yment. Laura StiV`Sfieedy <br />Assistant City Attorney <br />**Certificate holder continues: its officers, employees, agents, volunteers <br />and representatives. <br />CERTIFICATE HOLDER CANCELLATION <br />CITYSA3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO <br />DATE THEREOF, THE ISSUING INSURER WILL MAIL 30 DAYS WRITTEN <br />City of Santa Ana, * * NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT KNWQQM000=SHALL <br />Sgt. Marty Shirey/Canine Unit IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />20 Civic Center Plaza M-30 REPRESENTATIVE . <br />Santa Ana CA 92702 _^u1RUKLWKFR90ENTATIVE <br />ACORD 25 (2001/08) Kath ] `"AoWjl CPCiT/ ( —Vp <br />© ACORD CORPORATION 1988 <br />Any one persons $ 10 , 000 <br />PERSONAL 8 ADV INJURY $ <br />GENERAL AGGREGATE I� $ 2 0 0 Q o o o <br />PRODUCTTSS- COMP/OP AGG $ 1, 000 000 <br />-1,00-0,_000 <br />COMBINED SINGLE LIMIT <br />10/01/09 (Ea accident) $ 1,000,000 <br />10/01/08 <br />i BODILY INJURY $ <br />(Per person) <br />BODILY INJURY <br />(Per accident) <br />I PROPEI RTY pgMgGE <br />(Per accident) $ <br />AUTO ONLY - EA ACCIDENT ! g <br />OTHER THAN EA ACC $ <br />AUTO ONLY: ---------._-_ .__._-._ <br />AGG $ <br />EACH OCCURRENCE $ 5 000 000 <br />10/01/08 <br />10/01/09 AGGREGATE — $ 5, 000 000 <br />I $ _ <br />WC STATL;_ <br />X TORY LIMITS ER <br />07/01/08 <br />07/01/09 EL EACH ACCIDENT $ 1,000,000 <br />EL DISEASE-LAEMPL',, EE, $ 1, 000, 000 <br />--------- --- ----- - ----_. <br />E DISEASE - POLICY LIMIT $ 1 , 000 , 000 <br />APPROVED AS TO FORM <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />The certificate holder is named as additional insured. <br />10 -day notice of cancellation for non-payment. p yment. Laura StiV`Sfieedy <br />Assistant City Attorney <br />**Certificate holder continues: its officers, employees, agents, volunteers <br />and representatives. <br />CERTIFICATE HOLDER CANCELLATION <br />CITYSA3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO <br />DATE THEREOF, THE ISSUING INSURER WILL MAIL 30 DAYS WRITTEN <br />City of Santa Ana, * * NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT KNWQQM000=SHALL <br />Sgt. Marty Shirey/Canine Unit IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />20 Civic Center Plaza M-30 REPRESENTATIVE . <br />Santa Ana CA 92702 _^u1RUKLWKFR90ENTATIVE <br />ACORD 25 (2001/08) Kath ] `"AoWjl CPCiT/ ( —Vp <br />© ACORD CORPORATION 1988 <br />