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DEDVE-1 OP ID: AD
<br />'`'??""? CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DO/Vl'VY)
<br /> 08/06/12
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TH13
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must b® endorsetl. li SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an entlorsement. A statement on this certificate does not confer rights to thB
<br />certificate holtler in lieu of such endorsement(s).
<br />PRODUCER 888-762-3143 EACT
<br />NA
<br />Veterinary In S. 30rV ices CO. M
<br />
<br />CA License #OF64180 916-921-2266 PHONE ..._- FAX ...... .......
<br />A c rvo i. A/C Nol:
<br />1400 River Park Drive, ft180 E-MAU. -
<br />Sacramento, CA 95815 A. of€ss?_._._......__
<br />
<br />Kathy R. NOB, CPCU, ARM -VP
<br />INSURER(S1 AFFOROlNO COVERAGE _
<br />NAICp
<br />..._._..._. ...... INSURERA:FIreman?9 Fund InSLIra nCe CO.
<br />INSURED Detlicated Veterinary Care InC
<br />
<br />John W
<br />Thompson INSURER B:
<br />.
<br />3021 Edinger Avenue INSURER c
<br />Tustin, CA 92780 -'
<br />INSURER D
<br />__ ??-??????????
<br /> INSURER E
<br /> INSURER F
<br />THIS IS TO CERTIFY THAT THE POLICIES OF 1NSU RANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTI FIGATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
<br />,
<br />EXG LU SIO NS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDVCED BY PAID CLAIMS.
<br />IL IR TYPE OF INBURAw CE L POLICY NUMBER POLJCY EFF
<br />MM/OD/YYW POLIC E%P
<br />MMlDDIVYW "-'--
<br />LIMITS
<br /> GENERAL LIABILITY
<br />EACH CCCURRENCE
<br />5 1.000,00
<br />A X COMME RGIAL GENERAL LIARIL ITY X ZGS0876945 07/01/12 07/01/13 PREMISES a occurrence 5 100,00
<br /> CLAIMS-MADE ? OCCUR
<br /> MED EXP (An one person) 5 10,00
<br /> PERSONALb ADVIWURY E
<br /> ?
<br /> GENERAL AGGREGATE 000
<br />5 2
<br />00
<br /> ,
<br />,
<br /> GEN'L AGGREGATE LIMIT APPLIES PER:
<br />
<br />PR
<br />PRODUCTS -COMP/OP AGG
<br />???
<br />E 1,000,0
<br /> O- LOG
<br />X POLICY Emp Ben_ ? 5 1,000,00
<br /> AUT OMOBILE LIABILJTY M IN IN LE LIMI
<br />Eaawaenl
<br />S 1,000,00
<br />A ANY AUTO
<br />ALL OWNED SCHEDULED AZC80876945 07/01/12 07/01/13 BODILY IIWURY (Paf poram) $
<br /> ' AUTOS AUTOS
<br />NON-0WNED BODILY WJURY (Per aCGtlant) i
<br /> X HIRED AUTOS' X
<br />
<br />AUTOS
<br />R DAM -
<br />
<br />S
<br /> Per arsitlmt
<br /> 5
<br /> Jt UMBRELLA LIAR OCCUR E-CH OCCURRENCE 5 S,000,OOO
<br />A EXCESS LWB CLAIMS-MADE AZC80876945 07/01/12 07/01/1$
<br />AGGREGATE
<br />D00
<br />E ? S
<br />000
<br /> ,
<br />,
<br />????
<br /> DED RETENTIONS S
<br /> WORKERS COMPENSATION
<br />' N!C STATD- TH-
<br />X
<br /> AND EMPLOYERS
<br />LIABILITY ?,! N ORY LiMITS_ _
<br />A ANY PROPRIETOR/PARTNERIEXECUTIVE
<br />OFFICER/MEMBER EXCLI:OED? ?
<br />N / A ZP81004127 07)01/12 07/01/13 E.L. EACH ACCIDENT 5 1,000,000
<br />
<br />(Mandatary In NH)
<br />H yea
<br />tleacnba under __.
<br />E.L. DISEASE - EA EMPLOYE _._
<br />S 1,000,00
<br /> ,
<br />DESCRIPTION OF OPERF.TIONS bNOw E.L. DISEASE -POLICY LIMIT S 1,000,00
<br />A Professional Liab AZC80876945 07/01!12 07/01/13 Occurrent 1,000,00
<br /> Aggregate 2,000,00
<br />DESCRIPTION OF OPERATOrvS! LOCATIONS /VEHICLES (A [lath ACORD tot, Atltlitionai Remarks Scnanwe, x more spa I?..,,yy Iretl)
<br />Certificate holder is Hamad as additional insured ?YY ?.?) S/ i?_v /`?
<br />,j ? (
<br />) (1QRM
<br />.
<br />,
<br />30 Days No tics of Cancellation
<br />10 Days NOC for non-payment
<br />.4ssls LZr n:- Icy Attorney
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLIG IES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Santa Ana Police ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Animal Services
<br />Sgt Mark Koza kowski AUTHORIZED RE ENTATIVE
<br />60 Civic Center Plaza Kathy R. CP/L?J, /jRlA -VP
<br />1 / ._. !?_._...
<br />ante Ana, CA 92701 ,: y., ?./f
<br />® 1988-2010 ACORD CORPORATION. All rights reserved.
<br />v.i.vrcu m tzuT Ulua/ I ne AGC7RD Hama and logo are registered marks of ACORD
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