PROOF OF INSURANCE (2015) CLOSEDFax From StreemCenter
S,pp 29 '2014 11 :36PM HP Fax page 3
t-_--
t�
!
rr�
Personal Umbrella Policy
TRUCK INOUNWCE EXCHANGE
Transaatke Type: oFFER OF REN WAL iransnetied E
The policy is effective at 12:01 A.M. (uriless prior to the time applied for) at the named insttr
declarations.
Item I - Bask Information-,
95 60559 -16-27
Insured's hatee and Address:
GARY BUFKIN
1374 N LINDEN AVE
FRESNO CA 9372823;
Trust Nate:
Item 2. Rated Exposures
Owner Occupied Residence
Motorized Vehicle
Uninsured /Underinsured Motorist
Youthful Driver
Unlicensed Recreational Vehictr
Fmn: 01 -05 -$014
TV 01-05 -2015 03
iwh
NICOLE LERNO INSURANCE
7636 N INGRAt4 AV #102
FRESNO CA 93711
Aw. No: 95 45 376 j gad
1 Sailboat
1 Power Boat
Rental Units
Business Eaposures
Insured as an Employee
M;111
re Date: 01-0.5-2014
address shown in these
214.00
INC
(559) 999 -9005
Teachers Li bi °y
Farm WIA ty
Vacant Lwx ft tat acres)
Child Care
]et Ski /Jet Sled
Itoni 3.5diedefo of Uud8rlyietg lnsttrcttnco Limit of Insurance in, thousands Of dollars
I portant Notice: You lt'ave told us lrau have underlying insurance policies with liability krauts hs ted below. if the underlying
policies teen, mate or the. liability limits are less shown below, in the event of a covered loss we w" only pay those damages
w p p the limits and policies were in place as scheduled. You must the covers s d lariats below in effect
tyre mould have aid if
to avoid s in your protection.
INSURANCE CoMpANY
FIRE INSURANCE EXCHANGE
Item 4. Lanais
Poky limns
Each Occurrence
Limits of Liability $ 1,000,005
Retained Limit $ 250
Unimured/Underinsuzed Motorist NOT COVERED
183005040 AUTO LIABILITY
936520422 HOZOOWNER
* ** Continued * +*
Item 5. pof c At
ti!l
mcymvily Do not pay - invoice se
r
BILLING NO: BQ
$ 2 14. 0 0 Premium
Fees *
N/A Total*
This Declarations page is part of your policy. It supersedes and controls anything to
the contrary. It is otherwise subject to all other teams of the policy.
56.5169 2001110H 6.12 11 -12 -2013
Insured Copy
250/500/100
300
eep6arately
i ADl}ITIONAE FEE
,011 MTI5" K BElow
air Ap a*he
4•1 (5169201
Page 3 of <
Fax From StreemCenter
S -p 23 2014 11:36PM HP Fax
page 2
COMPANY NAME:
Each Person Each Dmrrm
$250,000 $soo,000
$100,000
I compreherlshM De w"
MID- CENTURY INSURANCE COMPANY, LOS ANGELES, CALIFORNIA
$1,00 Dedaretible
EVIDENCE OF INSURANCE FOR LIENHOEDER INTERESTS
Eat& Person fodi (ktortern
htwred's name and address:
Cover
Bodily Injury
GARY BUFKIN
POD Cy Na
1831
PmperV Damage
P6111 OW
2Nr
1374 N LINDEN AVE
EFEE( I DALE:
08/1
FRESNO, CA 93728 -2320
EXWT 0W DAIS
COIN
UMUCH lure
12:0
Page 2 of.
UNTIL CANCEII.ED
Standard Time
llabilDy
Bod Injury
�v
PMPetty Damop
Each Person Each Dmrrm
$250,000 $soo,000
$100,000
I compreherlshM De w"
$1,00 ble
Deductible
$1,00 Dedaretible
VNINSURED MOO
Eat& Person fodi (ktortern
Towing
Cover
Bodily Injury
$250,000 $500,000
Her
Cover d
PmperV Damage
Co red
NOR4 to I Llohl V
Not ve
141a¢IlcalfUa Tault
Not Covered Not Covered
.a.:..._r
Not ve
This evidence is subject to all of the to ns, conditions and limitations set forth in the pc
attached to it. It is fiemished as a matter of information only and does not change, modify
way. It supersedes all previously issued certificates.
1st Lienholder:
AMERICREDIT
PO BOX 1617
MINNEAPOLIS MN 55440 -1617
Authorized Representative
AGEN-f NAME &ADDRESS:
Nicole M Lemo
7636 N Ingram Ave Ste 102
Fresno, CA 93711 -6200
2540 5-08
Additional Interest;
WILLDAN ENERGY SOL.
2401 E KATELLA AVE
ANAHEIM CA 92806 -59
4
AGENTNO: 95 �45� 276
AGENTPHONE: 55 1999,
and endorsements
d the policy in any
A6439101
Fax From StreemCenter
S,±p 23 2014 11 :36PM HP Fax
To
Name
page 1
FARM{ E R Sm
INSURANCE
HOME — AUTO—LIFE N HEALTH— COMM
Nicole Lerno Insurance Agenc
7636 N. Ingram Ave. Suite #102
Phone (559)449 -9700 Fax (559)449 -9712
Email — Cynthia ,nlerno.@fasmcrrageney,com
Licence #OG06719
Rebecca Stack Fax:
e"" 94"44 ;044&4
Gary Bufklns
(310)322 -4167
Date: 09/23/2014
Pages: 3
Urgent ❑ For review ❑ Please comment ❑ Please reply O Please
Y L
"Please feel free to contact us if any questi n arise,
we are happy to heir).
Page 1 of
Shillin , Mona
IMEMMMM
From: Shilling, Mona
Sent: Monday, January 12, 2015 10:32 AM
To: Garcia, Angelina
Cc: Wesson, Venus; Stack, Rebecca
Subject: FW: Bufkin- scope and insurance
Angie,
When we meet in the next couple of minutes can I get a copy of the updated proof of insurance from you please.
Thanks,
Mona S
From: Garcia, Angelina
Sent: Wednesday, November 05, 2014 6:02 PM
To: 'Gary V. Bufkin'; Lee, Sam
Cc: Shilling, Mona
Subject: RE: Bufkin- scope and insurance
Mr. Bufkin,
We will accept the insurance provided. We will evaluate for reasonableness if the nature of the work changes in the
future.
Thanks,
Angelina Garcia
From: Gary V. Bufkin fmailto:garybCd)psnw.com]
Sent: Tuesday, November 04, 2014 4:47 PM
To: Garcia, Angelina; Lee, Sam
Subject: RE: Bufkin- scope and insurance
According to my agent, what she sent you yesterday, is what has been sent over the past several years.
I have never seen the cert before, my insurance agent handles that, the one you just sent me is the first I've seen for El
Segundo. As far as the type of cert I didn't know there was a difference, all I ever tell my agent is that a client needs an
insurance certificate.
Do I need to get have my policy changed? It's been the same since I've been doing work for El Segundo for the past 12
years? I talked to my agent and that is a separate policy than what I have now, but it will basically be another insurance
policy that I will need to carry that none of my other clients are requiring?
Thanks for the feedback, and please advise,
Gary