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BUCKNAM INFRASTRUCTURE GROUP INC. 1 - 2015
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BUCKNAM INFRASTRUCTURE GROUP INC. 1 - 2015
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Last modified
2/1/2018 6:43:22 AM
Creation date
2/3/2017 3:20:09 PM
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Contracts
Company Name
BUCKNAM INFRASTRUCTURE GROUP INC.
Contract #
A-2015-290-1
Agency
PUBLIC WORKS
Council Approval Date
12/15/2015
Expiration Date
12/31/2017
Insurance Exp Date
9/16/2018
Destruction Year
2022
Notes
Amends A-2015-290
Document Relationships
BUCKNAM INFRASTRUCTURE GROUP INC. - 2015
(Amends)
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\Contracts / Agreements\_PENDING FOLDER\READY TO DESTROY IN 2022
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------ 1) . <br />Page 1 of 1 <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDDNYYY) <br />COMMERCIAL GENERAL LIABILITY <br />09/18/2017 <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(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Willis of Illinois, Inc. <br />c/o 26 Century Blvd <br />P.O. Box 305191 <br />CONTACT <br />NAME; <br />PHONE 1-87 <br />A1C No Ext: 7-945-7378 IC No; 1-888-467-2378 <br />E-MAIL <br />ADDRESS: certi£icatea@willis.com <br />Nashville, TN 372305191 USA <br />INSURERS AFFORDING COVERAGE NAlc# <br />INSURER A: Continental Casualty COmpanY 20443 <br />INSURED <br />Eiucknafn Snfrastructur® Group, Inc, <br />INSURER B : <br />INSURER C; <br />3548 Seagate Way, Suite 230 <br />Oceanside, CA 92056 <br />INSURER D: <br />INSURER E: <br />INSURER.F <br />-� <br />r:nvrRerrS nCor�e�nw�rr � �en�non <br />- - -- rccv1Q1U1v rvumrscK: <br />------------------- <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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 TYPE OF INSURANCE L R POLICY NUMBER MMD y IFF fNMYDDYYY P LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE OCCUR <br />EACHOCCURRENCE $ <br />rrence $ <br />_ <br />MED EXP {Any one erson $ <br />PERSONAL 8 ADV INJURY $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ PECOT- ❑ LOC <br />GENERALAGGREGATE $ <br />- <br />PRODUCTS - COMP/OP AGO $ <br />OTHER: <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />COMBINED SINGLE LIMIT $ <br />Ea accident <br />BODILY INJURY (Per person) $ <br />_ <br />BODILY INJURY (Per accident) $ <br />PROPERTY DAMAGE <br />Per accident <br />S <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE S <br />AGGREGATE $ <br />DED RETENTION <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPRIETORIPARTNERIEXECUTIVE <br />OFF ICER/MEMBEREXCLUDED? <br />NIA <br />$ <br />PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT S <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E, L. DISEASE - EA <br />__ EMPLOYEE $ <br />E.L. DISEASE -POLICY LIMIT $ <br />A <br />Professional Liability <br />MCH288359767 <br />09/16/2017 <br />09/16/2018 <br />Per Claim: $2,000,000 <br />Aggregate: $2,000,000 <br />DESCRIPTION OF OPERATIONS! LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace is required) <br />�RLVIEVI4EC) [3Y:FUNICE HEFtEDIA <br />�,�' <br />rs;�-nctrnrc ung Hers <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />The City of Santa Ana AUTHORIZED REPRESENTATIVE <br />20 Civic Center Plaza M-36 <br />Santa Ana, CA 927D1 „ / <br />U 1U00 -LU -10 AL uRu GURPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />SR xo: 15062940 aA'rcn: 448854 <br />
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