BUCKNAM INFRASTRUCTURE GROUP, INC. - 2014

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1 49 ACC)RO CERTIFICATE OF LIABILITY INSURANCE DATE (MMIODIYYYY) 09/15/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S)I AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policyles) must be endorsed. 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 (s). PRODUCER Willia C£ Illinois, Ina. c/o 26 Century Blvd CONTACT NAME. . PHONE F N :1- S _467.2370 No E 3 -997 -9 S• A(Qa.... EMAIL ADDRESS P.O. a.. 305191 Naehv111a, 1'N 372305191 USA INSURERS) AFFORDING COVERAGE RAID ,,,, INSURER AICentin..lal Casualt Co. an 20993 IINSUREOBuotnae infsastrnetuce Group, Inc. IN6URER 8: $ INSURER C: CLAIMS -MADE ❑ OCCUR 3348 Seagate Way, Suite 230 INSURER O: Ocaanside, CA 92056 INSURER E: DAMAGE R 0999 w6uREa F: MED E %P (An one person Dance CERTIFICATE N UMRFR•WS65600 REVISION NUMBER: V THIS IS TO CERTIFY THAT 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN6R TYPE OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 9 UR pOLICV NUMBER .wlcyYVYY MMIOpY EXP, LIMITS AUTHORIZED REPRESENTATIVE The City or Santa Ana 20 Civic Centex Ploaa M -S6 COMMERCIAL GENERAL LIABILITY Pont. An., CA 92701 EACHOCCURRENCE $ CLAIMS -MADE ❑ OCCUR DAMAGE R 0999 S MED E %P (An one person $ PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGO S POLICY PROT . ❑ LOO JEC OTHER: AUTOM091LE LIABILITY COMB NED SINGLE LIMIT Ee accident $ BODILY INJURY (Per person) S ANY AUTO BODILY INJURY (Per accidano $ AUTOSNED SCHEDULED AD NON -OWNED PRO PERTYD e AMADE 0 °� $ HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS VAB CLAIMS -MADE DED RETENTIONS WORKERSCOMPENSATION STA UTE I, 5 - E L. EAACH ACCIDENT S AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEUEXECUTIVE E.L.OI6EASE•EA EMPLOYE 5 OFFICERIMEMBER EXCLUDEOT ❑ IN andetory In NH) NIA. E.L. DISEASE - POLICY LIMIT 5 If yes, tlescd0a under DESCRIPTION OF OPERATIONS below A profeasional Liability MCE280359767 09/16/2014 09/16/2015 ,000,000 Per Claim F$1,00 0,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS (VEHICLES (ACORD 101, Addltionai Remarks SCNadule, may be attabM1ad if mare space is required) W13tRFZU14AVVKU UVKrUMAnVrv. MH nglBSrube,Veu. ACORD 25 (2014101) The ACORD name and logo are registered marks of gCnO R,07oea953 BATCH: Batch #: 84769 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE The City or Santa Ana 20 Civic Centex Ploaa M -S6 n � Pont. An., CA 92701 W13tRFZU14AVVKU UVKrUMAnVrv. MH nglBSrube,Veu. ACORD 25 (2014101) The ACORD name and logo are registered marks of gCnO R,07oea953 BATCH: Batch #: 84769