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09/03/2008 05:32 5416079349 DELTA CONSTRUCTION <br />3 ~ ~ <br />OREGON WORKERS' COMPENSATION <br />CERTIFiCA7E OF INSURANCE <br />CERTIFICATE HOLDER: <br />CITY OF EUGENE <br />PUBLIC WORKS, ENGINEERING DEPT <br />244 EAST BROADWAY <br />EUGENE, OR 97401 <br />PAGE 06106 <br />•` sa r <br />/corporation <br />The policy of insurance listed below has been issued to the insured named below for the policy <br />period indicated. The insurance afforded by the policy described herein is subject to all the terms, <br />exclusions and conditions of such pollcy. <br />POLICY NO. POLICY PERIOD ISSUE DATE <br />521750 10/01/2007 TO 10/01/2008 09/02/2008 <br />INSURED: <br />BABB CONSTRUCTION CO <br />pELTA CONSTRUCTION CO <br />999 DIVISION AVE <br />EUGENE, OR 97404-2414 <br />Bodlly Injury by Accident <br />Bodily Injury by Dlsease <br />Bodlly Injury by Dlsease <br />DESCRIPTION OF OPERATIONSlLOCATlON315PECIAL ITEMS: <br />Job #4376 <br />North Game Farm Road <br />$500,000 each accident <br />$500,000 each employee <br />$500,000 pollcy Ilmlt <br />IMPORTANT: <br />The coverage described above is in effect as of the issue date of this certifcate. It is subject to <br />change at any time in the future. <br />This certificate is issued as a malker of information Only and confers no rights to the certificate holder. <br />This certificate does not amend, extend or alter the coverage afforded by the policies above. <br />CANCELLATION: <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL 30 DAYS' WRITTEN <br />NOTICE TO THE ABOVE NAMED CERTIFICATE HOLDER. <br />AUTHORIZED REPRESENTATIVE <br />3r~~.1P ~~+~ <br />President andJCEO <br />®SAIF CORPORATION i 400 High St SE i Salem, 4R 97312 i P: 800.285.85251 www.salf.com <br />BROKER OF RECORD: <br />WARD INSURANCE AGENCY INC <br />p0 BOX 10167 <br />EUGENE, OR 97440 <br />LIMITS OF LIABILITY: <br />0910312008 wED 08:26 [TX/RX NO 5014] ~ 006 <br />