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Burrola, Melissa <br />From: City of Santa Ana <certificate-request@ctrax.jdidata.com> <br />Sent: Wednesday, January 25, 2023 8:22 AM <br />To: peter@bucknam-inc.com, certificate@hanover.com; Gilbert, Hayley; Burrola, Melissa <br />Subject: Internal Notice of Compliance <br />NOTICE OF COMPLIANCE <br />CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL <br />Contractor Bucknam Infrastructure Group Inc <br />Name: <br />Project TBD (038) <br />Number: <br />Project Amendment To Agreement To Provide Pavement Management Program <br />Name: And GIS Map Integration Services <br />The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the <br />insurance requirements. No further action is required at this time. <br />The compliant coverage(s) are: <br />TYPE OF INSURANCE <br />AUTOMOBILE LIABILITY <br />GENERAL LIABILITY <br />PROFESSIONAL LIABILITY <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />Thank you, <br />POLICY EXPIRATION COI DATE <br />NUMBER DATE <br />OBCA39995608 <br />09/16/2023 <br />09/20/2022 <br />OBCA39995608 <br />09/16/2023 <br />09/20/2022 <br />LHCH02371703 <br />09/16/2023 <br />09/23/2022 <br />WZCA39994608 09/16/2023 <br />FILE NAME <br />BUCKNAM <br />INFRASTRUCTURE <br />GR_CityOfSantaAna_9- <br />20.pdf <br />BUCKNAM <br />INFRASTRUCTURE <br />GR_CityOfSantaAna_9- <br />20.pdf <br />BUCKNAM <br />09/20/2022 INFRASTRUCTURE <br />GR_CityOIS antaAna_9- <br />20.pdf <br />1 <br />