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ACOI~p,M CERTIFICATE OF LIABILITY INSURANCE oaiia/2o ' <br />PRODUCER (541) 687 -1117 FAX (541) 342-8280 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Inc . <br />Ward Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ~ • <br />, HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P 0 Box 10167 _ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Eugene, OR 97440 ' _n <br />Bob Powe I I INSURERS AFFORDING COVERAGE NAIC # <br />INSURED WILDISH CONSTRUCTION CO ,.,~s., ~ ~ 'i~;;`?d, <br />, INSURER A: TraVelerS PrOpert Casualt Co <br /> <br />PO Box 7428 _ <br />INSURER B: <br />Eugene, OR 97401 I ~ ~. ~ ~ <br />' INSURER C: <br /> y <br />m. '" r, ~~"" <br /> INSURER D: <br /> INSURER E: <br />C VERA ES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINI( <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />THE INSURANCE AFFORDED BY <br />MAY PERTAIN THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />, <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> GENERAL LU161LITY CO 504D7504 01 /20/2004 01 /20/2005 EACH OCCURRENCE S 1 , DpQ , aQ <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S 300 , Q <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) S 5 , QQ <br />A PERSONAL & ADV INJURY S 1 , D()D , QD <br /> GENERAL AGGREGATE S 2,DQQ,()D <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG S 2 , DDD , QD <br /> POLICY PRO LOC <br />JECT <br /> AUTOMOBILE LIABILITY 810-504D7504 D1 /2D/20D4 D1 /2D/2DD5 COMBINED SINGLE LIMIT s <br /> X ANY AUTO (Ea accident) 1 , D~ , DD <br /> ALL OWNED AUTOS BODILY INJURY S <br /> SCHEDULED AUTOS (Per person) <br />A <br /> X HIRED AUTOS BODILY INJURY S <br /> X NON-OWNED AUTOS (Per acddent) <br /> <br /> PROPERTY DAMAGE S <br /> (Per acadent) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO OTHER THAN EA ACC S <br /> AUTO ONLY: AGG S <br /> EXCESSAIMBRELLA LWBIIITY EACH OCCURRENCE S <br /> OCCUR ~ CLAIMS MADE AGGREGATE S <br /> S <br /> DEDUCTIBLE S <br /> RETENTION S S <br /> WC STATU- OTIi- <br /> WORKERS COMPENSATION AND <br /> EMPLOYERS' LIABILITY E.L. EACH ACCIDENT S <br /> ANY PROPRIETOR/PARTNERlEXECLITIVE ' <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE S <br /> If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT <br />S <br /> OTHER <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECUIL PROVISIONS <br />E: CONTRACT #2004-20 GARDEN WAY FROM SISTERS VIEW AVE TO MARTIN LUTHER KING JR BLVD <br />ERTIFICATE HOLDER IS ADDED AS ADDITIONAL INSURED (PER CGD246 & CAT301) THIS POLICY IS PRIMARY <br />ND NON-CONTRIBUTORY BUT ONLY AS RESPECTS TO THE WORK PERFORMED BY THE INSURED <br />N THIS PROJECT IN ACCORDANCE WITH THE POLICY TERMS AND CONDITIONS <br />F L <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> 3D DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LffFT, <br /> BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />C 1 TY OF EUGENE <br />244 EAST BROADWAY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />EUGENE, OR 97401 AUTHORU~DREPRESENTATIVE .' <br />i l <br />.~~...~' ~' <br /> N; <br />Bob Powell/KRIS <br />ACORD 25 (2001108) VE+cultu cvrcrvlv~uwn ~aov <br /> <br />