MIKE PRLICH & SONS, INC. - Laserfiche WebLink

Home Browse Search

712/1/2025 E(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 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 THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)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 CONTACT NAME: Tina Wolter Acrisure Southwest Partners Insurance Services, LLC PHONE FAX 4000 Westerly Place A/C No Ext: 949-486-7932 A/c,NO): E-MSuite 110 ADDRESS: twolter@acrisure.com Newport Beach CA 92660 INSURER(S)AFFORDING COVERAGE NAIC# License#:BR-1801370 INSURERA:Zurich American Insurance Company 16535 INSURED MIKEPRL-01 INSURERB:American Guarantee&Liability Insurance Company 26247 Mike Prlich &Sons, Inc. INSURERC: Great American Insurance Company 16691 5103 Elton St. Baldwin CA 91706 INSURERD: Navigators Specialty Insurance Company 36056 INSURERE:Allied World National Assurance Company 10690 INSURER F: COVERAGES CERTIFICATE NUMBER:457659116 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY Y Y GL0714349902 8/1/2025 8/1/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR PREMISES DAMAGE TO PREMISES Ea occurrence) ccurrence $300,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y BAP714350202 8/1/2025 8/1/2026 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED FIR ERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident C UMBRELLALIAB OCCUR Y Y TUE405237304 8/1/2025 8/1/2026 EACH OCCURRENCE $15,000,000 X D LA25EXCZOM3NFIC 8/1/2025 8/1/2026 X EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000,000 DED RETENTION$ $ A WORKERS COMPENSATION Y WC714349702 8/1/2025 8/1/2026 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE FN] N/A E.L.EACH ACCIDENT $1,000,000 OFFICE R/M EMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 E Pollution/Professional Y Y 03139429 8/1/2025 8/1/2026 Aggregate $10M Professional Liab $2M Occ/Agg Pollution Liab $5M Occ/$10M Agg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:On-Call emergency Asphalt Concrete, Concrete,and Storm drain Repair" Tu Tran Tu TralnyNguye by Agreement#A-2024-069-02 RFP#23-182 The City of Santa Ana, it's officers,employees,volunteers and representatives are named as Additional Insured as respects to Date:2025.12.3 General Liability as per endorsement attached as required by written contract. N 9 Uyen 10:14A7-0e'o Primary/non-contributory endorsement included.Waiver of Subrogation as respects general liability,auto liability and workers comp. 30-day notice of cancellation/10-days for non-payment of premium. APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 10:14 am,Dec 03,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92702 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD