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<br />SERAN-1 OP ID: DT
<br />1A�,,,..' CERTIFICATE OF LIABILITY INSURANCE
<br />o6r2s/a
<br />D06126/ATS 01Yzol4
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subjoct to
<br />the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the
<br />certi0oate holder In lieu of such endorsements .
<br />PRODUCER
<br />Veterinary Ina, Services Co.
<br />CA License #OF64180
<br />1400 River Park Drive #180
<br />Sacramento, CA 9581�
<br />Kathy R. Noe, CPCU, ARM -VP
<br />NAME:
<br />rao�a------.--..__._..._._.._...—______ .—_._..
<br />ac Ne): 916-g21-2286
<br />1t1d...EX0:888.762.3143
<br />ADDRESS:
<br />,_._,.___�___ INSURER(S) AFFORDING COVERAGE
<br />INSURERA: Fireman's Fund Insurance Co.
<br />_ ...........NAIC#
<br />INSURED Serrano Animal &Bird Hosp, in m
<br />Scott H. Weldy, DVM
<br />21771 Lake Forest Drive #111
<br />INSURER 9:
<br />_.. .__......._._.._....
<br />NSURERC:
<br />—
<br />INSURER D:
<br />Lake Forest, CA 92630
<br />INSURER E:
<br />INSURER F : .."_...—....._,__
<br />,.
<br />COVERAGES CERTIFICATE NUMBER: RFVIRInN NUMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />INSR
<br />LTR
<br />TYPE GF INEDRANOE
<br />POLICY NUMBER
<br />POLICY EFF
<br />M 01YYYY
<br />1 VIWxa-
<br />MWDD/YYYY
<br />—""-"-'-
<br />UMRS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,0
<br />CLAIMS-MADEOCCUR
<br />C10111150
<br />/71/112014
<br />TO EIREEfl0—_
<br />s 100,0
<br />MED EXP (Any one pawn)
<br />..__._.__.�_._....__......
<br />is 10,
<br />PERSONAL&ADV INJURY Is
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />_
<br />I$ 2,000,000
<br />X POLICY ❑JECT LOC
<br />PRODUCTS-COMPIOPAGG
<br />S 2,000,
<br />s
<br />OTHER'
<br />AWOMOBILE
<br />LIABILITY
<br />E0N1 1NEDISI L UMII
<br />—00
<br />IsIdW1,000,0
<br />A
<br />ANYAUTO
<br />A7C80897850
<br />07/0112014
<br />07/01/2016
<br />BODILY INJURY(Pw pen m)
<br />is
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY tPer aodden0
<br />j $
<br />hi,
<br />XNON-OWNED
<br />AUTOS AUTOS
<br />PR PE 5WAZ,�_HIRED
<br />Rs a dent
<br />$
<br />is
<br />UMBRELLA LIAR
<br />_ OCCUR
<br />EACH OCCURRENCE
<br />y
<br />AGGREGATE
<br />$
<br />EXCESS LIAR
<br />` CLAIMS -MADE
<br />DEC. I I RETENTION$
<br />$
<br />WORKERS COMPENSATION
<br />PER GTH-
<br />X ST,r�TyTE ER
<br />ANDEMPLOYERS'UABILITY YIN
<br />El. EACH ACCIDENT
<br />Is 1,000,000
<br />A
<br />ANYPROPRIETORPARTNERIEXECUTIVE
<br />ZP81020444
<br />07101/2014
<br />07/01/2015
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatm In NH)
<br />NIA
<br />E.R. DISEASE -EA EMPLOYEE
<br />i 1r0Wr0
<br />Kgqea, I.gbeunder
<br />OESCRI 1 N OF 0 ERATIONS belmv
<br />E.L. POLICY LT
<br />t
<br />I$ 100
<br />DESCRIPTION OF OPERATIONS/ LOCATONS IVEHICLEB (ACORD 101, AddlBonal ROMA$ SCaadma, may hY MtachM Umaro apace Is mqulmdl
<br />City of Santa Ana, its officers, agents, employees and volunteers are
<br />included as addtional insureds. The insurance provided is primarryy.
<br />"The insurance provided under this polio' is primary C non contributory withh ,Ef As' TO roRm
<br />'(t
<br />any other insurance available to the additioaal insured" �0 •ED _
<br />30 Days NOC/10 Days HOC for non-payment
<br />LtSA E. SiC)RttorneY �
<br />CERTIFICATE HOLDER CANCELLATION A55D*L`-
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Fin $ Mgt Svcs Agency
<br />AUTHORIZED ggeEPRHSENTAT VE
<br />Purchasing Div.
<br />20 Civic Center Plaza M-16
<br />Kath 'Mce, C W, ARM -V
<br />,Santa An CA 92701
<br />t%L7 --
<br />0M
<br />/ 011988-2014 ACORD COFPCOATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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