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T00 ~ [ 0959 'OItI fi0f~ L~ :9T lsOiQ 600Z/9T/80 <br />Y <br />~ I <br />Certificate of ~ILSUrance <br />X115 CERTIFICATE IS ISSUED A5 A MATTER OF INFORMATION ONLY ANO CONFERS NO RIGHTS UPON TNT: CERTIFICATE HOLDER. THIS CERTIFICAT$ <br />~i'S_;NQT AN INSURANCE PoLiCY ANa DOES NOT AMEND EXTENDi OR ALTER THE COVEkAGE AFFORDED ESY THE POLICIES LISTED <br />i <br />Thls is to Certify that <br />LILE INTERNATIONAL COMPANIES ~ <br />AMERICAN MOVERS <br />Pa sox loos <br />TUALATIN oR 97os2-1o0B j <br />•IIIluIutllln1YI11YUlalmltllrnlluuHnHuY111nn1111 <br />Liberty <br />Nortihwest, <br />Mct~tl~et r[ LbcnY Mvuul Wrap <br />P O Box 4555 <br />Portland, OR 97208-4555 <br />503.239.5800 <br />is, at the date of the oertificote; lnsurod by the Cvmperry undbr the poliey(ies) listed below. The Insurance afforded by She li:ted l~licy(ies) is <br />subject to ell their terms, exclusions and ~onditlons and Is bOt altered by eny roquirement, term or condition o1 eny contract or ether document <br />-:n~~ ,.~ aoa sa wmcn sma C9RITI Caie ma be iSSUee. <br /> EXPIRATION <br />1']'Pl# CIP POLICY DA-I-E POLICY NUMBER • i LIM1T5 OF LIABII.ITX <br /> COVERASE AFFDRDEb UNDER W.C. LAN OF <br />FOLLOWING STATES: tOVERACE AFFORDED UNDER w.t. LAYY Of <br /> <br />~X WoaKERS~ <br />• FOLLOWING STATES: <br /> <br />COMPENSATION <br />10/01/20D <br />WC4-1NC-001011 j OR <br /> I USL81H <br /> EMPLOYERS LIA61LnT LIMITS EMPLOYERS LIABILITY LIMITS <br /> ErtN Accidrtli S 500 , 000 Eeah Aeelenat S <br /> Dl~eare - voliry 111d11 S 500 ,000 Disease - pellet' Nmll S <br /> bthesse - eeeA employee S 500 000 Oiso.sa -arch employee S <br /> MARITIME COVERAGE-FOLLOWING STATES LIMIT OF LAB.-MAPI IME COPE A~ <br />GENEIIAL LIABILITY 6eherd Aparepsh S <br />Ceaaknlel Cnenl Wbduels Cemp/DPS Apprepete S <br />UablNty (OcgRrapcr) Pirsonal i adrertlsup lejrry S <br />ONaq's and <br /> Eseh Occarrsaca S <br />Cratrrktor's Prataetlve ilia bemspe Wry sae fire) S <br /> M ~dicrl E ense a eaa arson S <br />AUTOMOBILE LIABILITY <br />^ Any Ante CSL S <br />^ All ewaad Autos <br />Y <br />d <br />^ S Rodlly lalsry (Psr Person) S <br />c <br />tllad Altlss <br />o <br />• <br />Uodlly In)ary (Per Accldeed <br />S <br />^ Nlnd Aaty: <br />PrbpoMy Demrpe <br />S <br />^ Non-creed Autos j <br />^ Cwpd LUhlllq <br />^ ~ <br />bTHER <br />LDCariDN) Da OPERATfbNS E JOB s (IF APPLICA6LE) ~ DESCRIPTION OF OPERATroNS <br />EUGENE DEPOT/ AMTRAK STATION MOVE ~ <br />i FAX TO 541-682-6222 & 541681-3544 <br /> SHOULb ANY OF THE ABOVE DESCRIBEd! POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF <br />THE ISSUING <br />CANCE~LATION• , <br />COMPANY WILL ENOEAVOA TO MAIL 30 GAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT <br /> FAILURE 70 MAIL SUCH NOTICE SMALL IMPOSE NO 08LIGATION OR LIABILITY OF ANY KlNO UPON THE COMPANY, OR <br /> REPRESENTATIVES- <br />. I <br />MAILED fi0: <br />CITY OF EUGENE <br />~" FACILITY MANAGEMENT DIVISION <br />210 CHESHIRE AVE <br />EUGENE OR 9y401-2268 <br />Ilrlrlllulflnllhntnllnl[Inllitllululnllllllnlllanl <br />CERTIFA <br />EFS Ik a/1s/QD04 PORTLAND Underwriting <br />DATE ISSUED OFFICE <br /> <br />t0/i0 'd 86bl9EtE05 'ON X~d MN"I Gid Ztr.~O NOW ~on7-4t-~nH <br />