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ACORD~„ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYI~ <br />08/25/2008 <br />PRODUCER (541)687-1117 FAX (541)342-8280 <br />Ward Insurance Agency, Inc. <br />P 0 Box 10167 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Eugene, OR 97440 <br />Robert A Harvey <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED K1pC0 Inc. INSURER A: NOrth PdC7flG Ins CO <br />90465 Woodruff INSURER B: <br />Eugene, OR 97402 INSURER C: <br /> INSURER D: <br /> INSURER E: <br />CAVFRArFC <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <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 LIABILITY CO8 160647 08/10/2008 08/10/2009 EACH OCCURRENCE $ 1 000 00 <br />' <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ <br />300, OO <br /> CLAIMS MADE a OCCUR MED EXP (Any one person) $ 5 OO <br />A ~ PERSONAL & ADV INJURY $ 1 <br />OOO <br />00 <br /> ~ <br />~ <br /> GENERAL AGGREGATE $ 2 OOO <br />OO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG , <br />$ 2 OOO , OO <br /> POLICY jECa LOC <br /> AU TOMOBILE LIABILITY C08 160647 O8/lO/2008 O8/lO/2009 COMBINED SINGLE LIMIT <br /> E $ <br /> X ANY AUTO a accident) <br />( 1 OOO OO <br /> ALL OWNED AUTOS BODILY INJURY <br /> <br />A <br />SCHEDULED AUTOS <br />(Per person) $ <br /> X HIRED AUTOS <br />BODILY INJURY <br /> <br />X <br />NON-0WNEDAUTOS <br />(Peracddenl) $ <br /> PROPERTY DAMAGE <br /> $ <br /> (Per acddent) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO EA ACC <br />OTHER THAN S <br /> AUTO ONLY: qGG $ <br /> EXCESS/UMBRELLA LIABILITY CO8 160647 08/10/2008 08/10/2009 EACH OCCURRENCE $ 4 ~ 000 ~ 00 <br /> X OCCUR ~ CLAIMS MADE AGGREGATE $ 4 ~ 000 ~ OO <br />A <br /> $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND WC STATU- OTH- <br /> EMPLOYERS' LIABILITY <br /> <br /> ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br />ff yes <br />describe under E.L. DISEASE - EA EMPLOYEE $ <br /> , <br />SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ <br /> OTHER <br />NSTALLATION FLOATER C08 160647 08/10/2008 08/10/2009 $150,000 LIMIT <br />A 51,000 DEDUCTIBLE <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />E: ROBIN HOOD AVENUE STORM MODIFICATIONS JOB#4571 -CONTRACT 2009-04 <br />ITY OF EUGENE IS ADDED AS ADDITIONAL INSUREDS (PER LGL4032 dt CA2048); GENERAL AGGREGATE SHALL APPLY <br />EPARATELY PER PROJECT (PER CG2503) AS RESPECTS TO THE WORK BEING PERFORMED BY THE INSURED ON THIS <br />ROJECT IN ACCORDANCE WITH THE POLICY TERMS AND CONDITIONS <br />CITY OF EUGENE <br />244 EAST BROADWAY <br />EUGENE, OR 97401 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE ,.~r <br />!r, ~,/ten ~',.f(~..,< < <br />Rob Harvey/CARSON ~ ~~ <br />ACORD 25 (2001/08) rA~: but-u41V ©ACORD CORPORATION 1988 <br />