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PAYMENT NO 1 15 662096 J CLAIM NO 37-6R20-219 <br /> PAYMENT AMOUNT $5,084.56 LOSS DATE 07-01-2015 <br /> ISSUE DATE 09-17-2015 POLICY NO 2205-697-37G <br /> AUTHORIZED BY HAGER, SARAH INSURED SWANSON, ALICE D <br /> PHONE (866) 291-3429 <br /> CITY OF EUGENE PUBLIC WORKS <br /> 1820 ROOSEVELT BLVD <br /> EUGENE OR 97402-4159 <br /> REMARKS for 376r20219 <br /> COVERAGE DESCRIPTION ON BEHALF OF AMOUNT <br /> PROPERTY DAMAGE LIABILITY CITY OF EUGENE PUBLIC WORKS 5,084.56 <br /> RETAIN STUB FOR RECORDS <br />