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~ . .. a "a~, _ . , <br />;v` <br />• ~~ . ' ~~( ', ' . ' . ' .~ :. ', -, <br />%f'~ ' Certificate of lnsurance <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POUCY AND . <br />DOES NOT~AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLIqJES LISTED;BELOW. ~ ~ ~ - ~ ~ <br />i~u~:~c~~aM~ <br />+ ~ .: ;, ~ L~berty <br />This is to Certify that ~l ~~~`~~es~ ,- <br />~ ~ ; ,;:}~;:~;_~`}`. A Liberty Mutual Company <br />~ Cora1 Construction Company; . <br />Coral Corporation of'Oregon, Inc. Lloyd Center Tower <br />P.O. Box 347 . 8L5 N~ Multnomah Street <br />I Wi 1 sonvi 11 e, OR 97070 ~ Yortland, Oregon 97232 <br />(503) 23J-5800 <br />is, at the date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) <br />is subject to all their terms, exclusions and conditions and is not altered by any requirement, term or condition of any contract or other document <br />with respect to which this certificate may be issued. <br />TYP~ OF:PO.uCV, .:: ExP~a710N oAT~ `>_ PQL,tGY; NuMRER " ; !LIMITS`:O F LIABIUTY.::..... ; : ; ; <br />;, :, . ~ ~ . ~- ~ ~ COVEH.4GE AFFORDED UNDER W C. LAW UMIT Of LIABILITY-COV 8 <br />WORKERS~ OF FOLI.OWING STATES <br /> EACH <br /> 0-1-89 W 4-1NC-001010 OI~Cg'OR BI by Accident $~~~ACCIDENT <br />COMPENSATION <br />. <br />~ , <br />~ ~ . Poucv <br />8.1 ~y Disoese $ ~~~_ LIMIT <br /> EACH <br /> ~ _ , , . . . ~ 8I. by Disease $ EMPLOV EE <br />. ~ bV1qITIME COVERAGE - FOLLOWING STATES LIMIT OF LIABIIITY - A I I OVERAGE <br />GENERAL LIABIUTY <br />^ Commercial General ~ General Aggregate $ <br />Liability (Occurrence) <br /> Products Comp/OPS Aggregate $ <br />~ Owner's and I <br />l <br />Ad <br />ti <br />i $ <br />Contractor's Protective s <br />njury <br />Persona <br />ver <br />ng <br />& <br /> Each Occurrence $ <br />^ Fire Damage (Any one fire) $ <br />^ Medical Expense (Any one person) $ <br />AUTOMOBILE LIABILITY <br />^ Any Auta CSL $ <br />^ All owned Autos E3cdily Injury (Per Person) $ <br />^ Scheduled Autos Bodily Injury (Per Accident) $ <br />^ Hired Autos Froperty Damage $ <br />^ Non-owned Autos <br />^ Garage Liability <br />^ <br /> <br />OTHER <br />LOCATION~S) OF OPERATIONS 8 JOB ~(IF APPLICABLE) DESCRIPTION OF OPERATIONS <br />Mahlon Sweet Airport; #3-41-0018-07 <br />i <br />~ SHOULD ANY OF THE,ABOVE DESCRIBF.Q,POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING <br />o COMPANY WILL ENDEAVOR TO MAIL ,x~ DAYS WRITTEN NOTICE TO THE C[HTIFICATE HOLDER NAMED BELOW, BUT <br />FAILURE TO ,MAIL SUCH NOTICE SF~L IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, OR <br />REPRESENTATIVES. ` <br />MAILED TO: <br />~City of Eu~ene <br />858 Pearl St. 4th Floor ~ <br />F.ugene , OR 97401 <br />Attn: Tom Frey <br />L ~ <br />F~rm LNW 3004 ~Rev ~/ABI- <br />.~.`"`4 <br />,.. <br />~ i~'~I `' . _ ' ~j-. - .. . <br />~• <br />, ~ y~ <br />. -+ v; :. y'`!~-~: i,.y~,.~-. <br />AU~HORIZED REPRESENTATIVE <br />JTf[ 3-29-£f9 Partland <br />~ DATE ISSUED OFFICE <br />