WELDY, SCOTT H. a/k/a SERRANO ANIMAL & BIRD HOSPITAL 5A - 2010

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A ^ !R ^® /`il�ViL! CERTIFICATE OF LIABILITY INSURANCE OP ID AD DATE (MM/DD/YYYY) 06 17/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the po Icy les must be endorsed. , subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Veterinary Ins. Services Co. UUMMl NAME: PHONE TAT_ A/C, No, Ext : (A/C, No): CA License #OF64180 ADDRESS: 1400 River Park Drive, #180 Sacramento CA 95815 Phone:888-762-3143 Fax:916-921-2266 PRODUCER CUSTOMER ID #: SERAN-1 INSURER(S) AFFORDING COVERAGE NAIC# INSURED Serrano Animal & Bird Hospital Scott H. Weldy, DVM INSURER A: Fireman's Fund Insurance Co. INSURER B : INSURERC: 21771 Lake Forest Drive #111 Lake Forest CA 92630 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR AZC80841431 07/01/09 07/01/10 PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL aADVINJURY $ X RENEWAL OF AZC80841431 07/01/10 07/01/11 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 X POLICY PROT LOC JEC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS APP OVED F bRM COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS J EPH L TCHER PROPERTY DAMAGE (Per accident) $ $ NON -OWNED AUTOS (_ ATTOR E TCy $ A X UMBRELLALIAB OCCUR AZC80841431 07/01/09 07/01/10 EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE s2,000,000 DEDUCTIBLE $ X $ RETENTION $ WORKERS COMPENSATION _ AND EMPLOYERS' LIABILITY Y / N ANY PROP RIETOR/PARTNER/EXECUTIV OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A TORY LIMITS ER E.L. EACH ACCIDENT _ _ $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ A Umbrella/Excess RENEWAL OF AZC80841431 07/01/10 07/01/11 Occurrenc $1, 000, 000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Santa Ana, its officers, agents, employees, representatives and volunteers are named as additional insured 30 Days notice of cancellation 10 Days notice of cancellation if non-payment CER I iFiGA I t HOLDER CANCELLATION City of Santa Ana Parks, Recreation & Community Service Agency -Athena Martinez P.O. Box 1988M-23 Santa Ana CA 92702 ACORD 25 (2009/09) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. TIVE Kathy R. Noe, CPCU, ARM -VP © 1988-2009 The ACORD name and logo are registered marks of ACORD All riahts reserved