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CERTIFICATE OF INSURANCE <br />This certifies that ®STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois <br />' ^STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois <br />^ STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario <br />^ STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida <br />^ STATE FARM LLOYDS, Dallas, Texas <br />insures the following policyholder for the coverages indicated below: <br />Name of policyholder Thompson, David <br />Address of policyholder 9440 Theona DR., Eugene OR. 97902 <br />Location of operations <br />Description of operations <br />The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is <br />subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid',cliitims. <br /> <br />POLICY NUMBER <br />TYPE OF INSURANCE POLICY PERIOD <br />Effective Date ;Expiration Date LIMITS OF LIABILITY <br />(at beginning of policy period) <br />97-ER-1695-8 Comprehensive 09/07/2005 09/07/2006 BODILYINJURY'AND <br /> Business Liability $1, 000, 000 PROPERTY DAMAGE <br />This insurance includes: ®Products -Completed Operations <br /> ® Contractual Liability <br /> ^ Underground Hazard Coverage Each Occurrence $ 1, ooo, o0p <br /> ^ Personal Injury <br /> ^ Advertising Injury General Aggregate $ 2, 000, 000 <br /> ^ Explosion Hazard Coverage <br /> ^ Collapse Hazard Coverage Products -Completed $ 2, 000, 000 <br /> ^ Operations Aggregate <br /> <br /> <br />EXCESS LIABILITY POLICY PERIOD <br />Effective Date ;Expiration Date BODILY INJURY AND PROPERTY DAMAGE <br />(Combined Single Limit) <br /> ^ Umbrella Each Occurrence $ <br /> ^ Other Aggregate $ <br /> Part 1 STATUTORY <br /> Part 2 BODILY INJURY <br /> Each Accident $ <br /> Disease Each Employee $ <br /> Disease -Policy Limit $ <br /> <br /> <br />POLICY NUMBER <br />TYPE OF INSURANCE POLICY PERIOD <br />Effective Date ;Expiration Date LIMITS OF LIABILITY <br />(at beginning of policy period) <br /> <br />97-ER-1695-8 Business Propert 09/07/2005 ~ 09/07/2006 $2,200 <br /> <br />THE CERTIFICATE OF IN SURANCE IS NOT A CONT RACT OF INSURANCE AND NEITH ER AFFIRMATIVELY NOR NEGATIVELY '' <br /> <br />AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. <br />If any of the described policies are canceled before <br />its expiration date, State Farm will try to mail a Written <br />notice to the certificate holder 3o days before <br />cancellation. If however, we fail to mail such notice, <br />Name and Address of Certificate Holder no obligation or liability will be impos on ',,State <br />rm or it ag s or represent tives. <br />ADDITIONAL INSURED: <br />City of Eugene <br />210 Cheshire St. Signature of Authorized presentative <br />Eugene, OR. 97901 Insurance Acct. Re 01/09/2006 <br />Title Date <br />Agent's Code Stamp <br />AFO Code F473 <br />558-994 a.3 04-t999 Printed in U.S.A. <br />