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Home My WebLink AboutCOMMUNITY VETERINARY HOSPITAL, INC. 2Br AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Deputy Clerk of the Council (M-30). Call 647-5238 if you have any questions. -__ -------------------- The agreement with /~'.'h;~j~- c . y ~ ~'-~;~c'-~1.~.~ tit A z ~ - ~ _~~ ~~~- ~- was completed on l ~j 3 ~ ~ ~~ 1 ana final payment has been made. AGREMNT Department: ~ n NUMBER SUFFIX ~ ~ ~` ; , ~- ~ --~- -- ~_.3~..! Signature: ~ ~ 'N-2005-068 2 ~J i ~ <:? s ;~ ~. ~ . __ __ A-2006-095 ,2a Date: c ~. ~ 3i :~ ~a N-2005-068-01 '2b ~~ '~ ~~ ~- (41., Lw~ N-2005-068-02'2c City of Santa Ana Clerk of the Council Revised 05-22-05 "'1NSUR~NCE ON fiLE '/"',K MAY PROCE~PIRES \ . ;lLlNSURANCE nY f)-I-M . WC:7-/- CLERK Of c6uil& DAlE: Y-IJ<>7 0: ~\SCQ\ (z) ) CLef, BfbWr'l N-2005-068-01 SECOND AMENDMENT TO AGREEMENT THIS SECOND AMENDMENT TO AGREEMENT is entered into on the / day of '-full ,2007, by and between COMMUNITY VETERINARY HOSPIT L, INC., a CalifornIa corporatIOn ("Consultant") and the CIty of Santa Ana, a charter city and municipal corporation of the State of California ("City"). RECITALS: A. The parties entered into Agreement N-2005-068, dated May 24, 2005, (hereinafter "said Agreement") by which Consultant has provided veterinary services for Police Service Animals. B. In accordance with the terms and conditions of said Agreement, the parties wish to renew said Agreement for an additional one-year period, and increase compensation to pay for services during the extended period. WHEREFORE, in consideration ofthe covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this First Amendment to Agreement, the parties agree as follows: I. Section 2.a., COMPENSATION, shall be deleted in its entirety and replaced with the following: "City agrees to pay and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under said Agreement shall not exceed $25,000.00, annually, during the term of said Agreement." 2. Section 3, TERM, shall be amended to extend the term for an additional one year period, through June 30, 2008. 3. Except as herein amended, all terms and conditions of said Agreement shall remain in full force and effect. II II II II .. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Agreement on the date and year first written above. CITY OF SANTA ANA ATTEST: Ma DAVID N. REAM City Manager ~-- _ rC. 11M,.... ./ PATRICIA E. HEALY Clerk ofthe Council APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney BY:~'A~J; Lau a Sheedy Assistant City Attorney APPROVED AS TO CONTENT: CONSULTANT / (Jo L\-J PAULM. WALTERS Chief of Police t41~'"~ Chief of Staff . l,j. COMMUNITY VETERINARY HOSPITAL, INC 13200 EUCLlQ ST. GARDEN GROVE, CA 9284a . ......:'4 "...... FEE SCHEDULE Effective 9/1/06 EHF $3.00 '$27.00 Office Call & Exam Recheck Exam Injections (dose/drug dependent) $24.00 $27.50--$35.50 Radiographs (large, two views) $85.00 Radiographs additional views $30.00 sm / $40.00 Ig Complete blood protne (CBC/Chemffhyroids) $85.00 Heartworm blood test $22.75 Urinalysis $28.75 Urine Collection Fee $0.00--$15.00 Heartguard 272mg $35.00 Sentinel 51-100 Ibs $65.00 IV Catheter $32.50 Hospitalization/day Based on weight Canine $28.50 $34.50 $39.50 $44.50 $50.00 EXHIBIT A 1-25 Ibs 26-50 Ibs 51-751bs 76-1001bs > 100 Ibs : ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY) 07/13107 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Association Unit ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ABD Insurance & Financial Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 2480 Natomas Park Dr. Suite 200 Sacramento, CA 95833 N-ZOOS -Ob8-01 INSURERS AFFORDING COVERAGE NAlC # INSURED INSURER A: Fireman's Fund Insurance Community Veterinary Hospital, Inc. INSURER B: 13200 Euclid Street INSURER c: Garden Grove, CA 92843 INSURER 0: INSURER E: Cllent#- 18321 COMMUVETE COVERAGES 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 SUeJECT TO All THE TERMS. EXCLUS'ONS AND CONDIT'ONS OF SUCH ~~ES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAJDCLAIM~ ~ I!JB.~ TYPE OF INSURANCE POLtcYNUJilBER ~~ ~~ LNrrs A ~NERAllIABIUlY AZC80806n1 10/01/06 10/01107 EACH OCCURRENCE X COMMERCiAl GENERAL LIABILITY DAMAGE TO RENTED I CLAIMS MADE [ij OCCUR MED EXP (Anyone person) PERSONAL & ADV INJURY GENERAL AGGREGATE x I Tmi_STADi~ I ,OJ);'- E.l. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPlOYEE $1 000000 E.L. DISEASE - POLICY UMIT $1 000 000 - ~LAGGRE~ LIMIT AP~ PER: I I POLICY I I ~~Ri I IlOC ~TOMOEULE UABlUTY ~ ANY AUTO I-- All OWNED AUTOS ~ SCHEDULED AUTOS I-- HIRED AUlDS I-- NON-DWNED AUTOS I- PRODUCTS-OOMP~PAGG COMBINED SINGLE LIMIT (Eaaccideflt) BODilY INJURY (Per person) BODILY INJURY (Peraccidenl) PROPERTY DAMAGE (Per accident) rlRAGE LlABlUJY H ANY AUTO AUTO ONlY - EA ACCIDENT OTHER THAN AlITOONLY: A AZC80806771 10/01/06 10/01/07 ~ESSJUMBRElLA UA8lUTY W OCCUR 0 CLAIMS MADE h DEDUCTIBLE Iii ~ETENTION $ 0 A WORKERS COMPENSATION AND EMPLOYERS' UABlLITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERlMEMBER EXCLUDED? If yes, desaibe under SPECIAL PROVISIONS below OTIiER EACH OCCURRENCE AGGREGATE WZP80952231 07/01/07 07/01108 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PR<MSlO"'~ r .. Supplemental Name .. Doing Business As: Community Veterinary Hospital, Inc. (dba) Animal Friends Pet Hotel (dba) Animal Discount Clinic (See Attached Descriptions) "0, of ._ ) i,.., T: i( ." --C~ /l:f ""._.10 ,_ CERTIFICATE HOLDER CANCELLATION TAn- , fnr $1 000 000 $100 000 $10000 $1 000 000 $2 000 000 $2 000 000 $ 5 5 5 EA ACe AGG $ 5 5 55 000 000 55 000 000 5 5 5 ..... City of Santa Ana 20 Civic Center Plaza, M.30 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POIXIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENOEAVOR TO MAIL -30..- DAYS WRITTEN N011CE TO THE CERTIFICATE HOLDER NAileD TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABlUTY OF AHY KIND UPON THE tNSURER, ITS AGENTS OR REPRESENTATIVES. ~~~ POLICY NUMBER: AZC80806771 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON or ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Santa Ana 20 Civic Center Plaza, M-30 Santa Ana, CA 92702 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your operations or premises owned by or rented to you. Certificate Holder is named Add'l Insured as respects to Veterinary Services performed by the named insured. , : \,"'~ -_.-/~... ,~)"~. ,,1 ,.., \ l~_' . -. . /\',... ,i. ' DESCRIPTIONS (Continued from Page 1) William A Grant & Virginia L Grant, Trustees oflhe Grant Family Trust, agreement dated 3/26/80 as respects Improved real property Certificate Holder is named Add'llnsured as respects to Veterinary Services performed by the named insured. LoC# 1 . 13200 Euclid Sl; Garden Grove, CA LoC# 2 . 13252 Euclid Sl.; Garden Grove, CA LoC# 3 . 13220 Euclid St.; Garden Grove, CA \~ . I"'" 1\.. ~ __ __/15!} L-\I " A U~ ")c ., ,.".not InO\ "I _'''1 ........nftft'Yn.. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement{s), If SUBROGATION IS WAIVED, subject to the terms and condijions 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does tt affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon, .I "-,,,-) ,r'J..') L~ --- '_ l.'i i-\L; l:.'';~' r ACQ~I;:-CERTIACATE oFL'Aa,urY!NsJ[~\~::==Ii";~~ ~i'.n;;-ue.;;" ~ ~.. d. ~~--- -..T----- 0';- I THI!\C!~T"IC~.T!'S ISSIJ!D 1\5 A MA.n!" n~ iNFORMATION \ AIls c'allon U it f'4 .. ;)CO{p- 0-,,,, , 0'''''' ANn CONfER' ilJo) RJ~'''T$ VI,,;,'l TI.E ~;!InIfICATE o , n HOLDER THIS CER'TIFICATE DOES NOT AMEND, EXTEND OR. ABD In.v'11~"9 If< FillS""I.1 ...",1"'" rJ ~.;;J.005 - 00 g I AlTER THE COVERAGE AFFOIlDEO eY THE PO~ICIES eELDW. 2480 NatamM Par!< D,.l'lulto! 20 Sacral'lll!nto, CA 95833 t:lt)' uf' Sa.,ta Ail" , , "I' ::I.l Cl'Wic; ee:".otEtI' ?I~ZU, llff:):)' 5'l"'t""".,::;"'n~/A'_' .' ' y-,. . .,_ ,,__,__"._~__~._~,._,"...__,!,...._...~:...' .____ _.,..__~'...._.;:;r"'.r--.' ACORn2&~'20()1J08i1 ",!~ .1QSti~1' Ii \.!lv . ') ''\UI'J ':'cy 1~; 18/ ~~2 rl\':~ ----- INS.UR~l') Community Veterin 1~l3~ E.:...:c:lrl ~~L,~,:t G,;.J.;':!G!"j GroW'.': J\ .----..------- C~VERAG~_ ._ THE POLICIES OF INSUR;"NC~ tls'ni: ;'.H'I' RE(,"';lr.E~-,l:~ Ti=pM oR: Gf'lNO MAY l'!Ie.RiAI<.l, 1 ril:.lNbul{Ai-..::1: ;.,;=;:C POLICIES, AGGPET r..iE LlM1TS SHOIJ'; L~ HSR T\'~-,:,~ ':"!'_l~t\.!~~~_ A X Q',iHl'Ij:r,:~\",l,.'/n:\.IT,( X ,r.:"')~'''~~ !'l,":I'\1 '~i~"F.PAl. UA ~-:,=::~ t--. PO~!C'jn)tgT_L_- A'JtoMOBIl,.S UMllun r- "NY AL:TO L ALL O'.\'Mi[) 1\UTO,~ r-- SCHE.[llkEO AUTOS lllneDAllTOS ~ :::'"'::: T ~'~;'~GE wAel~;;--' n ANY AllTO -1 ElCCur,IllMSIU,I.\J<. LIABILITY - OCCUf\ rJ CI.A1MS , OcQUCT9l lW~ER~';;'~~;:~~~;;~;;~~'~.... l....LO'l'I:!\fI.U..,.ii.rr:. ANi P,,"'J~ r~:I::r:J!:;!pil,qn!~,"-!;l').";(.ll1l\J orm:~IVMr:t-.mr:R "X:GUK'~I)'i'- . If '}~~ t;lo:>.dO/i ')I'o:\l\r SI' IA i'i"i,'J....I~IONS bllll'~_._._ __ CiTH'EFI. ~___ __Wi'! U~;~, D~SCf\lPnrJNt... t'-rl~IV.T,O'U~ 1; 'X ~.:';;:;;;i .. $upplem~ntal N8m~ .. DOfng BlIsilless At.: Community (dba) Anima; frlend& Pet Hotd (dbal Animal DI.count Clinic (See Attached Oollt,;~iptl\3n:\} ..-.~. ..""~.~"-^" -'- -. ._~_.. CERTIF C T HOLDj!R 0 tJ-;;J.OD5 -()(pg-ol ~.-,..-....__.-_.--.~._~-~--_._.. ~~-,- -.- INSURERS AFFORDiNG COVER.6GE NAIC# __.........~,_.r. FiremBn's Fund Inaurance INaUPl.el'A.: -' ary HO$plla~ Ine, INSURER g. - , IN8URE.FtC. ,m.')3 -- lN~URER 0: , in.:W~er\~' o eEl-OW H'V. BE,iNISRt,EO TO THE INscREO NAMEO ABOVE FOR THE PDUCY P'RIGO INOIC,"EO. NOTWITHSTANDING ITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEClTO \\HICH THIS ,:EflTIFICATE MAY BE ISSUED OR ,'DEO BY THE POLICIES OESCPIOEO HEREIN IS SUBJECT TO ALL THElERMS. EXC ,USIONS ANO CONDITIONS OF SLJCH N M~ Y HAVE 8EEN REOUCED BY PAle ClI\IMS. ~~. '1~i6~o~~t;7Nt!~~'-----~--i~~;~~W~ I - "'~iT!' tMMlDC "'MilS WiO I/O. i!lICti o:::CU~Re':C:'; '1000 000 BUrry! , ~ I~:.GC \.;:,J'u:~r.~l) ~O I ~:'.. <':~, ,,.,,', ..-- r..cU~ 'I , i ~ .!-~,'.~ !,)(P J,llY ~M ilff'!trl u '10,000 , L~:~~~.~~~: ..~t~2~~';~~- ~1 000 nno - __L__L_. I l$:Nt--<AL A.~l:o""t: .2 000 000 .S PliRI I PFlOD'JCTS, ~i-.i~~;); AC:,C; .2.000 000 1 ., ~' i ~9.(-,---_____"_W-'--~--- _.- -- l!'Mel~~CSINGLE LIIYtT I (E 1 "~:~lc1er.',} i I BllOILVINJURY (r"!'<~er1Ionl . I ~ I I til1LJlL V INJUKY \, <p",raCCiOEnltl . ~~OP';RlY DAMAGF , I (P~! aCCIlU~nt) ! ~f!"OONL"t .f.AM:C10E~T . ! r".' ""' . "'1 l'l0 OtH..Y' AGO. ..!- - ~ - ~ ---.-..---" -- ,.- ""--.-..- -~~ .------ -.,------.. -- -~911~~~~C-~ -"- . iwl./lOe. .QlIGkl:GA f: . --~- I 1-- - - . , -- .. -- -..."..-- -.-.+.-.-.- I rx .l1~'~ ~Tf~ I -lo.r~-!Ii 'WZP80952231 07/Ot/07 07/01108 . ! ~ {}.C!-l ~,CC;l)r.:NT $1 000.000 --- ---t- ~~~~~f;~f $1000000 ~ i E, ~E~k:"Si:' p.).;..;:;v L1ioi I.~ .tlOO.OOO .~ .-.. , I ~_vHn/,G1 l ! J _~._ .__ _ _ "__.__._d_..____._._.__.__..'. _. -----.-.-----.---- V!!:l--!l":l.l::fi (~."C':LII!'i~ON'5 jJ)DED BV EI.,I[I"!\S~ENr /SPE.CIA.L PROVlstOm '..,'et~r\tUifY HO.j:J-U21,lm~. .,. __~_..W' ".~----------...-----. CAlIcaLA TIOII SHOULD ANV OF THli A50IJE tlE5-ClU6fP "OLleIES BE CANCELLED 8EFORF: THE D:PIRAnON ~I\r"$ r.'::.'Uf';"f ":~il:: It:;;"H-r, iH3uRi:F 'tA.:.1. '=Jo!~f.'/WC~,?,,}MAIL _-30- t1A'tSWRln$N 111:''Tjti~ ftl THf. cmnn-:.."f HOL!)F Q. 'II.MIW TO TItE LEn. BUT F~!I.L'Ra TO cO ljQ il'lAloL. d! lf1o~f t"lf') l)Dut:lA'!f.1N OAI..1Af!lllll,"t"" I,m I"IND uptlH TtiE! lNSUIltER. ITS AGENTS OR Mf'Ae 5 ~~.,..~r.~~,-- .,........-.-....--. '. ,l.(;Gll.::lCORPORATION 198B COMiolUVE:le J2i': 'f!.I "V -, Y' 1 '2/18!::':':v/ i (l ::::; ~: I'. i\ IMPORTANT ,f the certlfic~to holder is an ADDITIONAL INSURED, the pollcy(ie'J must be endorsed. A statement "n this certificate does not conrer righl. to the ,ertiRc"te holder in lieu of such endolsement{s) If SUBROGATION IS WAiVED, subject 10 tile larms and conditions oftl1e policy, certain policies may reqoire an end~ment. A statement On this certificate does no~ confer ri9hts to the certificate Mlde. In lieu of ~ut.h endorsement{s). DISCLAIMER The ':';'~.r~U;~II.(, :.f "l,{.;'!ll il /-; t..'\ t: ,I: ""fi"~:.''';: lidl' d tr:? ft"-rm does not constitute a contr~ct l>}atwEle", tl'e iss\ling ins\lre~s), autnQrized rspresentative or producer, and the certificate hQ'<Ier, oar 0".. It affirma~ltel1 or neg.tively omend, e.<tend or aller the coverage efforded by tM policies i1s18d ther.on. ACORD 25-S 1200tJO~) 2 afJ #1050447 .\2./18/211~l7 1" 2~1 F,lJ.X ~----_. DESCRIPTIONS (continued from Page ") ._-_.~----~._-_..~ ... ..~._.-.. ----.-. Willi;)."'" A Grant 8. ViQl111ia I... Grant. Trustees of the Grant \ Family Trust, agreement dated 3/28ltO as respects Improved ~ .".i,~~ ~.~':I\'(}rt)' .~--- ! \ C""tRcll1. Holder I" ".",,,,t Add'llnsured as respects to Veterinary ~Cf\;,I~l} !.'terformed b;.t th.a- famed Insured. toe# 1 .13200 Euclid St.; a.rden Grov., CA Loe# 2 _ 13252 Euclid St.; Garden Grov.. CA \ i,,,,,_ :1.13220 Euclid St.: Gorden Grove, CA AMS 26.a (Z001/08) 3 of3 _lD50447 .- -'---. . 1Z/18!20vl 11),23 FAX COMMERC:1AL GENERAL LIABILITY POLICY NUMBER: AZCBOS0677l THIS ENDORSEMENT CHANGES THE POLICY. PL.EASE READ IT CAftEFULL Y. ADDITIONAL INSURED. DESIGNATED PEHSON or ORGANIZATION ThIS "ndo~sement modifies insurance pro~ided under the following: COMMERCIAL GENERA\. LIABILITY COVERAGE PART SCHEDUlE Name of Person or Organization: Ci;:,y of santa Aleta 20 civic Center Plaza, M-30 San::a Ana, CA 92702 (If no <'mIry appears above. information required to complete this endorsementwili b9 shown in the Declarations 8S ~ppllcatlle to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insuled the person III organization shown In lhe Sciledule. but only with respect fJ:> liability arising out of YDur operations or pramhe$ owned by or rented to you. ced.ificat.e Holder is aam<.ed Add'l Insured as respects to 'Ieterinary Services perfo:t:med by the name,,:! i:i:lst'.tred. CG 20 2b 11 B~ OCT~ 24-cQG_18 a°: 10 FROM:CVMA 9266469183 T0: 714 2458550 P.1'3 ,~coRV CERTIFICATE OF LIABILITY INSURANCE aPID roc DATE(MWDDIVYYY) PRODUCER COI+NE-1 lO 24 0$ THIS CERTIFICATE IS ISSUED A3 A MATTER OF INFORMATION Veterinory xas . 3®rviCes Co . CA License #OS64180 ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE 1900 River park D~'ive #180 OT RD ~ E E , AL ER THE COVERAGE AFFO ED B THE POLIC ES BELOW_ 3acr~n~ CA 85815 phone:888~762-3163 Fax: 916-921-2266 INSURERS AFFORDING COVERAGE INSURED _ • NAIC i{ INSURER A; Fireman's l~W1a7 ineacanoa Co. C~nit veterinary Ho itel WSVRER B - ~ '- ~~ ltilllam ~ Grant jI , DVl~ INSURER C' Garde A o e - INSURER O. n Gr v CA 9 843 - INSURER E~ '- COVERAGES 'THE POltC1E5 Ot INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THC INSURED NAMED ABOVE FOR'iHE POLICY PERIOD INDICATED. NOTWITNSTANUING ANY REDUIRGMENT, TERM OR CONDITION OF ANY CONTRA T C OR OTHER DOCUMENT WITH RCSPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DES(:RI~O HEREIN IS SUBJECT TO ALL THE TEAMS PO C U I E . EXCLUSIONS ANO CONDITIONS OF SUCH S. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIM6 LL~~ ' LTR N Rtl TYPE OF INSURANCE POLICY NUMBER ~ ~ ~ ~ATt?CTIVE POQLWEYPf11A~jpN - - DATE NRIUDDm UMfTB GENERAL LIABILITY A R R COMMERCIAL GE NERpI LUIBILITY EACH OCCURR ENCC S 1, OOO r OOO BH`ASC60832674 10/01/09 10/01/09 PREMIStS(E.9oocurxlce) s 100,000 _ CLAIMS MADE ~ I OCCUR MED EXP (Any anp Qeraon) S 1O , OOO ~~ - PERSONAL 8 ADV INJURY 1 ~- GENERALAGGREGAfE S 2,000,000 OEN'L AGGREGATE LIMIT APPLIES PER; _ _ x POLICY JPERCT LOC PRODUCTS • COMPIDP AGG S 1 , OOO , OOO _ ~ AuTnlawLE uABILrn Hen • 1 000 000 ~ ANy AUTO s~~csos3z474 lO/Oi/O8 lO/O1/O9 COM9INED; INGLE LIMIT f 1 , OOO (Efi 80Citlenl r OOO ALl OWNED AUTOS _ Sf.NF,OVLED AUTOS BODILY INJURY f (Perperaon) R HIRED AUTOS _ NON-OWNED gUTpg BODILY INJURY f ~ ( sr ecTJCenI) t I. .. .. .. OARACE LIABILITY ANY AUTO BkCEBS/UMBRELLA LIA81LfTY I A OCCUR ~IcLAiMSMADE 8Ei4AZC80832471 10/01/08 DEDUCTIBLE x RETENTION 1 MIORKAgB COMPlNSATNk/ AND A OINPLOYERB' LIA&LRY ANY PRDPRIETDRlPARTNERfEXECUTIVE 18K6ilTLp80965134 07/01/08 O~tICER/MEMBER FXCLUDED9 Ilyes, pBBpIDB UIWvr ~w~rur ~n~w Vr OPERATIONS / 40CATION3! V EHlCLES / El(CLUSIONB ADDED BV ENDORSEMENT / SPiCIAL Tho certificate holder is named as additional ].nsurad. 10-day notice of cancellation for nos-payment. PROPCRTY DAMAOE I f (Par a¢iegnt} I AUTO ONLY • EA ACCIDENT $ OTHER THAN EA ACC 5 AU'fU ONLY. ACC i EACH OCCURRENCE ~S,OOO,000 _ 10/01/09 AGGREGATE s 5 000, OOO -_ - _. _.. ... I 1 .. .. 07/01/08 C.LEACHACClDENr 1],,000,000 E L DISEASE - EA EMPLOYEE 1 ], , OOO , OOO E,L. DISFA$ • POLICY IIMI, 1 O t_ .,, w.,_ ; .. ... , I ~/ INS ..... ...._ _,._..__..._..-.._ Laura Sig; `;:~~:n Assistant L: iiy f, tE orney **Certifi.cate holder continu®s: its officers, employees, agents, volunteers and reproaantativea. CANCELLATION CYTYSA3 SHOULD ANY OP TM4 ABOVE DEBCRNiED POLIGEB BE CANCELLED BEiIOR6 T-IE E1tPNGTIO DATE TNERiOP, THE IbSVlNO INSURER Will EMAIL 3O DAYS WRITTEIy Clty Of $aata Ana, ** NOTICE TO THE CERTIFICATE HOLDER NAMED TO TNi ~~.g~sNALL Sgt • Marty Shirey/Canine Tait IMPOSE NO OBLIGATION OR uAB11JTY OP ANY KIND UPON 7ME 1NSUR 20 Civic CeAt®r Plaza I"I-3O REPRESENTATIVE . 8R. 1T8 AOENTS OR Santa And CA 92702 nirru.,.~s e~ _--_-- - _ ACORD N-aoor-o6~-c~/ i~CT-24-2008 09:10 FROM:CVMA 9166469183 T0: 714 2458550 P.3~3 Additional Insured -Owners, Lessees or Contractors - AB 90 6712 93 Policy Amendment Section ll Insured Community Veterinary Hospital Policy Ntunber SH4AZC80832474 William A. Gtartt 11, DVM Producer Veterutary Ins Services Cn )affective .Date 1 0/0 1 12008 5ched ulc Numc of 1Peraoa(s) or Organization(s) City of Santa Ana, its officers, employees, agents, volunteers and representatives I'rimaryln,surunce: !t is agreed that such insurance as afforded by tlai.c policy for the benefit of the cldditional insured shall be primary inrura»~cy ~ respects any e~aim• lass or liability crrisi~g directly or indi,'eetly fro-n the insarred ;c operations and any vlher insurance maintained by the additional insured .durll be non-~unbibutorv with the insuaance provided hereunder. (If no entry appears above, information required tt- complete this Endorsement will be shown in the Declarations ns applicable tp this Lndorsement) Th(; tbllowing is Added co Part I -WHO [S AN tN- SURF..D in the Business Liability Section of this policy 5. The person or organization shown in the Schedule is also an insured, but only with respeeta to liability arising out ol'your work for that insured by or for you. All other terms and conditions ofthe policy apply. This form ntusc be attnchccl to Chtutgc Endorsement when issued aRer the policy is written. One of'tho Fireman's Fund insurance Companies ~ ntimcd in t}ic policy. tie0rctary - Presidcnt - Atlvp67 I?~93 C:onffiin~ c;npyR~~ -~atenol of tn.uraacc Scrvicr~ Utiiccs, Inc: , 19t{q r~Cj-24-2008 09:10 FROM:CUMA 9166469183 T0: 714 2458550 P.2~3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s}. If SUBROGATION IS WAIVED, 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(sj. bISCLAIMER The Certifcate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.