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BUCKNAM INFRASTRUCTURE GROUP, INC.
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BUCKNAM INFRASTRUCTURE GROUP, INC.
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Last modified
12/2/2021 4:11:11 PM
Creation date
12/2/2021 4:09:52 PM
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Contracts
Company Name
BUCKNAM INFRASTRUCTURE GROUP, INC.
Contract #
A-2021-211
Agency
Public Works
Council Approval Date
10/19/2021
Expiration Date
10/18/2023
Insurance Exp Date
9/16/2022
Destruction Year
2028
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OBC A399956 07 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />NOTICE OF CANCELLATION TO DESIGNATED ENTITY(S) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />HANOVER COMMERCIAL FOLLOW FORM EXCESS AND UMBRELLA POLICY <br />COMMERCIAL PROPERTY COVERAGE PART <br />BUSINESS AUTO COVERAGE FORM <br />BUSINESSOWNERS COVERAGE FORM <br />SCHEDULE <br />Name of Designated Entity <br />Mailing Address or Email Address <br />Number Days Notice <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PI (Md0) P.O. BOX 1988 BANTA AM, CA 92702 <br />30 <br />(Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) <br />If we cancel this policy for any reason other than nonpayment of premium, we will give written notice of such <br />cancellation to the Designated Entity(s) shown in the Schedule. Such notice may be delivered or sent by any <br />means of our choosing. The notice to the Designated Entity(s) will state the effective date of cancellation. <br />Unless otherwise noted in the Schedule above, such notice will be provided to the Designated Entity(s) no more <br />than the number of days in advance of the effective date of cancellation that we are required to provide to the <br />Named Insured for such cancellation. <br />Such notice of cancellation is solely for the purpose of informing the Designated Entity(s) of the effective date of <br />cancellation and does not grant, alter, or extend any rights or obligations under this policy. <br />ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. <br />401-1235 12 14 Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />Page 1 of 1 <br />d"en-W, <br />8ANN& <br />RhkMe�geRoefi%wvm <br />%u i�i[s.ar <br />Rek Matv9eimrt Ocicil AiA. <br />
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