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tieG'chez' c:arlsoni~t3LK 4/'L47LUU'/*'L:U4:'L;3 1~M 1~ACih L/UU~ raX Server <br /> ~Q (+OR~ DnrEIMWDOmvn <br /> CERTIFICATE OF LIABILITY INSURANCE a~24~2007 <br /> PRODUCER (541) 485-6633 FAX: (541) 485-3946 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> JBL6K Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDEf'L THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 59 E 11th Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> PO Box 70206 <br /> Eu ene OR 97401 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: SAIF Co oration <br /> Rowell .Brokaw Architects PC INSURER B: <br /> 1 E Broadway Suite 300 INSURER C: <br /> INSURER D: <br /> Eugene OR 97401 INSURERS <br /> THE POUGES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED i0 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br /> REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br /> THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND COWOITIONS OF SUCH POLICIES. <br /> INSR AOD'L ~ ~ POLICY EFFECTIVE POLICY EXPNtAT10N <br /> TYPE OF WSURANCE POLICY NUMBER DATE MMID DATE MMRJ LIMITS <br /> GENERAL LIABILITY ~ s <br /> COMMERCIAL GENERAL LIABILITY ~ G O ENTER e~ _ <br /> CLAIMS MADE ~ OCCUR MED EXP M oru ersm S <br /> S NA V' Y S <br /> GG G T f <br /> GEN'LAGGREGATELIMITAPPUESPER: -COMP G i <br /> U J CT LOC <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE OMIT f <br /> ANV AUTO (Ea ecckenq ' <br /> ALL OVYNED AUTOS BOCTLV INJURY <br /> SCHEDULED AUTOS (Perperam) E <br /> HIRED AUTOS BODILY INJURY <br /> NON-0WNED AUTOS (Per ealdeM) _ <br /> PROPERTY DAMAGE f <br /> (Pef iCCIdMa <br /> OARAOE LIABILITY AUTO ONLY • EA ACCIDENT 3 <br /> ANV AUTO <br /> OTHER THAN AA E <br /> AUTO ONLY <br /> AGG f <br /> EXCESSAIMBRELLA LIABILITY s <br /> OCCUR ~ CLAIMS MADE GR GAT S <br /> f <br /> DEDUCTIBLE <br /> S <br /> R ION s <br /> A WORKERS COMPENSATION AND 1MC STATU- OTH- <br /> EMPLOYERS' LIABILITY T V I IT <br /> ANY PROPRIETORJPARTNERIEXECUTIVE E.L. EACH ACCIDENT f 500 , 000 <br /> OFFICERAAEMBER EXCLUDERS 903951 7~1~2:006 7~1~2007 <br /> II yes, describe under E.L. DISEASE - EA EMPLOYE E 500 , 000 <br /> 1 s L. IsEAS • PO CV LIMIT s 500 , 000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONSJVEHICLESIEXCLUSIONSADDED 8Y ENDORSEMENT/SPECIAL PRONSIONS <br /> Re: West Eugene rret lands environmental education center. <br /> CERTIFICATE HOLDER CANCELLATION <br /> (541) 6B2-6222 sHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> City Of Eugene EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> 210 Cheshire Avenue 30 DAYS WRITTEN NOTICE TO THE CERTIFlCATE HOLDER NAMED TO THE LEFT, BUT <br /> Eugene, OR 97401 <br /> FAILURE TO DO b0 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> INSURER RSAOENTSORREPRE9ENTATIVES. <br /> AUTHORIZED REPRESENTATNE <br /> Jeryl Coleman/AMBESL U <br /> ACORD 25 (2001/08) ®ACORD CORPORATION 1988 <br /> <br /> INS026 Iotoal.osa <br /> Page ~ d 2 <br /> ~ - r ~ n ~ n n n <br /> <br />