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~ CERTIFICATE OF IRANCE <br />~ , ~ <br />wausau en urance Companoes ~ <br />.~.~ . - <br />This is to certify that the insurance policies (described below by`a policy number) written on forms <br />This certificate is not a policy or a binder of insurance and does not in any way alter, amend or extend <br />to herein. _ <br />Name and Mailing Address of Insured <br />~ ~ <br />Coral Construction Company <br />10780 SW Clutter <br />Sherwood, OR 97070 <br />~ ~ <br />~~ ~ ~dC~ <br />;, <br />~~~ , :~ ~ <br />Producer No.: 6203 <br />- Office: Beaverton, Oregon <br />Date: March 30, 1989 <br />Region: PO <br />Type of Insurance CO• <br />NO. Policy Number Palicy EHective <br />Date (MO/DA/YR) Policy Expiration <br />Date (MO/DAIYR) •• Unleas othervviae indicated, this pol~y affords tull cwerege under the <br />yyorkeis Com <br />ensation laws of a~l atates (exce <br />t states where covera <br />e <br />WO~~B <br />Compensation ** , p <br />p <br />g <br />can be provided,only by State Funds,..and Cer.ada) end as des(gnated <br />in the policy and endoreements for Part Two (Employers Liability). <br /> Liability Limita In Thoueanda (000 omitted) <br />Commercial General General Aggregate' . $ 2 000 <br />Liability 3 2320-00-047355 1-17-89 1-17-90 ~: praducts'& Comp./Opa. Aggregate $ 2 000 <br />Commercial Package or Personal & AdveRiaing Injury ; $ 1 OQ~ <br />Trademark (Section II anly) Each Occunence ~ $ 1 ~~~ <br />( ) Claims Made ( X) Occurrence Flre Damage (Any One Fire) $ S O <br />Products • Completed Operationa: ( X) Included ( ) Excluded Medical Ezpense (Any One Person) $ <br />Ownere & Contractors ` Aggregate $ <br />Protective Each Occurrence $ <br />auto usb~~ity 2 2320-02-047355 1-17-89 1-17-90 Single limit • Each Accident 3 1~ 000 <br /> <br />( X) All Owned Autos Bodily Injury <br />Each Peraon . <br />$ <br />( ) Speciffed Autos Only ~ Each Accident $ <br />( X) Hired Autos <br />( ) Nonowned Autos <br />" <br />- .- Property Damage <br />Each Accident ' <br />$ <br />Umbrelle <br />Each Occurrence <br />, $ <br />Liability General Aggregate $ <br /> Retention $ <br /> <br />Specfal Provlslons/Locatlons/Speciiled Autos: <br />Re: Mahlon Sweet Airport <br />~~3-41-0018-07 <br />Notwithstanding any requirement, term or condition of any contract or.other document with respect to which this certificate may be.issued or mey pertain, the insurance afforded <br />by the policy (policies) described above is subject to all of the terms, exclusions and conditions oi such policy (policies) during the term(s) thereof. <br />*The entry of a number in this column means that the coverage is afforded by the company designated by the same numbec .. <br />`Issuing Company~No. 02. EMPLOYERS INSURANCE OF WAUSAU A Mutual Company <br />Issued to: 03. WAUSAU UNDERWRITERS INSURANCE COMPANY <br />~ City of Eugene 07. iLLIN0IS EMPLOYERS INSURANCE OF WAUSAU <br />Attn: Tom Frey 01. WAUSAU LLOYDS <br />85g Pearl St. 4th Floor `~ ~.~~~ <br />Eu ene, OR 97401 <br />• Signed <br />~ ~ ~ Authorized Representetive <br />289~ (S) 80-324 <br />