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GJN3825 Woof Works Contract
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GJN3825 Woof Works Contract
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Entry Properties
Last modified
7/14/2008 2:52:48 PM
Creation date
7/8/2008 3:49:14 PM
Metadata
Fields
Template:
PW_Capital
PW_Document_Type_Capital
Contracts
PW_Active
Yes
External_View
No
GJN
003825
GL_Project_Number
905173
Identification_Number
2006100313
COE_Contract_Number
2006-03854
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~' <br /> <br />Certificate of Insurance <br />This certifies that: State Farm Mutual Co. of 6loomington, III. <br />had coverage in force for the following Named Insured as shown below: <br />Named Insured: Thompson, David <br />Insured's address: 4440 Theona DR., Eugene OR. 97402 <br />.Policy Number 046 OS26-A10-37A <br />Effective Date of the <br />Policy 01/10/2006 <br />through <br />07/10/2006 <br />Description of <br />Pro 1977 Toyota Pickup <br />Vin # : RN28103529 <br /> <br />Liabili <br />Per Person 1,000,000 <br />Per Accident 1,000,000 <br />Pro Dama a 1,000,000 <br />Personal Injury <br />Protection 15,000 <br />Comprehensive <br />deductible <br />Collision deductible <br />Uninsured Motorist <br />Per Person 1,000,000 <br />Per Accident 1,000,000 <br />Pro a Dama e 10,000 <br /> <br />Additional Insured: City of Eugene, 210 Cheshire St., Eugene OR. 97401 <br />State Farm Agent: Jason Stefely, 315 Coburg Road, Eugene, OR 97401 <br />Phone: (541)485-1315 Fax: (541)485-1272 <br />Countersigned: <br />by <br />
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