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i <br />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 <br />Location of operations <br />Description of operations <br />9440 Theona DR., Eugene OR. 97902 <br />The policies fisted 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 claims. <br /> POLICY PERIOD LIMITS OF LIABILITY <br />POLICY NUMBER TYPE OF INSURANCE Effective Date ;Expiration Date (at beginning of policy period) <br />97-ER-1695-8 Comprehensive 09/07/2005 o9/D7/20o6 BODILY INJURY 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, 000, 000 <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 /> POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE <br /> EXCESS LIABILITY Effective Date ;Expiration Date (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 /> POLICY PERIOD LIMITS OF LIABILITY <br />POLICY NUMBER TYPE OF INSURANCE Effective Date ;Expiration Date (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 30 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 />F rm or it ag s or represent tives. <br />ADDITIONAL INSURED: <br />City of Eugene ~l( <br />210 Cheshire St. Signature of Authorized presentative <br />Eugene, OR. 97401 Insurance Acct. Re 01/09/2006 <br />Title Date <br />Agent's Code Stamp <br />AFO Code F473 <br />558-994 a.3 04-1999 Printed in U S.A. <br />