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AGENCY CUSTOMER ID:BRENINC-02 CMALLAPUR <br /> LOC#: 1 <br /> ACORD ADDITIONAL REMARKS SCHEDULE <br /> Page 1 of 1 <br /> AGENCY License#0757776 NAMED INSURED <br /> HUB International Insurance Services Inc. James Breneman dba JB Infrastructure <br /> PO Box 1055 <br /> POLICY NUMBER Concord,CA 94522 <br /> SEE PAGE 1 <br /> CARRIER NAIC CODE <br /> SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br /> Description of Operations/LocationsNehicles: <br /> terms,conditions and exclusions. <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 /> ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />