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FORM NUMBER: <br />EFFECTIVE DATE: <br />The ACORD name and logo are registered marks of ACORD <br />ADDITIONAL REMARKS <br />ADDITIONAL REMARKS SCHEDULE <br />FORM TITLE: <br />Page of <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />ACORD 101 (2008/01) <br />AGENCY CUSTOMER ID: <br />LOC #: <br />AGENCY NAMED INSURED <br />POLICY NUMBER <br />CARRIER NAIC CODE <br />© 2008 ACORD CORPORATION. All rights reserved. <br />HUB International Insurance Services Inc. <br />BRENINC-02 <br />SEE PAGE 1 <br />1 <br />SEE PAGE 1 <br />ACORD 25 Certificate of Liability Insurance <br />License # 0757776 <br />1 <br />SEE P 1 <br />James Breneman dba JB Infrastructure <br />PO Box 1055 <br />Concord, CA 94522 <br />SEE PAGE 1 <br />SVENKATA <br />1 <br />Description of Operations/Locations/Vehicles: <br />Should the policies be cancelled before the expiration date, Hub International Insurance Services Inc. (Hub), independent of any <br />rights which may be afforded within the policies to the certificate holder named below, will provide to such certificate holder notice <br />of such cancellation within thirty (30) days of the cancellation date, except in the event the cancellation is due to non-payment of <br />premium, in which case Hub will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation <br />date. <br />Docusign Envelope ID: 3C863071-4B6E-41FC-AA87-DE901295C655