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—= H`C..V'KLJ CERTIFICATE OF LIABILITY INSURANCE DATE IMMRID/YYYY) V 7l31I2019 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 BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policyQes) must have ADDITIONAL INSURED provisions Or 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 Patriot Risk & Insurance Services 2415 Cam us Drive, Suite #200 NAME, PHONEg49 FAX Irvine, CA 92612 486-7900 N - sas aes 7s50 -NAILExth ADDRESS: INSURERS AFFORDING COVERAGE NAICe www.pairlsk.com OK07568 16535 INSURERA: Zurich American Insurance Company INSURED Mike Prlich &Sons, Inc. INSURERS: Navigators Insurance Company 42307 INSURERC: IronshoreSpecialty Insurance Cc 25445 5103 Elton St. Baldwin Park CA 91706 INSURERD: Llo ds of London INSURER E: INSURER F: CnVFRArOES lx KCVIaIUN NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OFOF ININSURANCE 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. INSR LTR TYPEOFINSURANCEimwa POUCYNUMBER M LICV EFF MMID IYYYYJ YEXP LIMITS A GOMMERCKLGENERALUABIUW GLO 7945139-00 8/1/2019 8/1/2020 CLAIMS4MAOE © OCCUR EACHOCCURRENCE $1000000 J $5 OOO Deductible PREMISES PREMISES Ea 0T00nenfa $100 000 EXP (Amy aM ern) $10 000 PERSONAL & ADV INJURY $1.000 000 GENL AGGREGATE LIMB APPLIES PER: POLICY PCTT LOC GENERALAGOREGATE §2,000,000 PRODUCTS-COMP/OP AGO $2000000 OTHER: f A AUTOMOBILE Lmeary BAP 7945142-00 8/1/2019 8/1/2020 E a I n. t IANY $1 000 000 $ OWNED OWNED SCHEDULED BODILY INJURY (Par p.) AUTOS ONLY AUTOS HIRED NON -AUTO NED BODILY INJURY (Per ectldaM) $ PRO,EERd DAMAGE $ AUTOS ONLY AUTOS ONLY ONLY f B UMBRELLA IJAB ,i OCCUR LA19EXC7820511V 8!1/2019 8/1/2020 EACH OCCURRENCE $10000000 EXCESS LIAR I I CLAIMS -MADE AGGREGATE f 10 000 000 DED I I RETENTION A WORKERS COMPENSATION $ WC 7988026-00 8/1/2019 8/1/2020 PT AND EMPLOYERS' LIABILITY YIN T ANMROPRIETORIPARTNERIEXECUTNE OFFICERRAEMBEREXCLUDEDY NIA E.L.EACHACCIDENT $1 OOO OOO (fM "abry M NH) Il yn dae�ib unJw EL DISEASE -EA EMPLOYE S DESCRIPTION OF OPERATIONS berm E.L DISEASE -POLICY UMIT $1000000 C Pollution Liability 004158100 '8/1/2019 8/1/2020 $2,000,000 Occur / $2,000,000 Aggregate D Professional Liability EL00-98-0088-2018 Deductible. 5/9/2019 5/9/2020 $1 000 non invvrencc/Annn.qate DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remwlu ScbedWa, may be affachad if more apace I. fagolr ed) Re: City of Santa Ana's Emergency Sewer and Water System Repair Services RFP 19-032. The City of Santa Ana, it's officers, agents, employees, s, volunteers and representatives are named as Additional Insured as respects to General Liability as per endorsement attached as required written contract. Primary/non-contributory endt attached.by 30-day notice of cancellation / 10-days for non-payment of premium. CERTIFICATE Hot nPR n.. ne_I. u_.-__.-_-.. mi.a-t_., City of Santa Ana Q �JOIe SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Risk Management Division V L li THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 9270z SAMANAJA M. LAMBERT AUTHORIZED REPRESENTATIVE r d Dave Jacobson ©1988-2015ACORD CORPORATION. All rights reserve „v r vmu flame ana logo are registered marks of ACORD sea e4 329 1 19/30 GL/AV/UMe/WC/POLL I Ti va Ken:,edy 1 7/111 Za 19curl !Soya 1 ,! 9 This certificate cancel. and supereedea ALL prev3ouely leauea ter-a-ace:es.