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SAIF Corporation 10/15/2008 9i25i45 AM <br />OREGON WORKERS' COMPENSATION <br />CERTIFICATE OF INSURANCE <br />LERTIFICATEHOLDER: <br />PUBLIC WORKS ENGINEERING CITY OF EUGENE <br />ATTEN:LYNN <br />244 EAST BROADWAY <br />EUGENE, OR 97402 <br />PAGE 1/001. Fax Server <br />, <br />"'~~~~~.,~, F <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 subjed to all the terms, <br />exclusions and contlitions of such policy. <br />I POLICY NO. POLICY PERIOD ISSUE DATE <br />i 627971 11/O1/2007 TO 11/O1/2008 10/15/2008 <br />INSURED: BROKER OF RECORD: <br />ELMS LANDSCAPE SERVICESINC <br />28780 ]AGER LN <br />JUNCTION CITY, OR 97448-9316 <br />~ LIMITS OF L148ILITV: <br />6odily Injury by Accident $500,000 each accident <br />Bodily Injury by Disease $500,000 each employee <br />6odily Injury by Disease $500,000 policy limit <br />DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIALITEMS: ' <br />IMPORTANT: <br />The coverage described above is in effect as of the issue date of this certificate. It is subject to <br />change at any time in the future. <br />This certificate is issued as a matter of information only and confers no rights to the certificate <br />holder. Thls certificate does not amend, extend or alter the coverage afforded by the policies <br />above. <br />AUTHORIZED REPRESENTATIVE <br />pji',~~ ~y'. #'cvG~d,it----~------.. <br />8 <br />Presfdent and CEO <br />q~~ S~IF CORPORATION I 400 Hi9h St SE I Salem, OR 97312 I P~ 800,285.8525 ~ www.saif.com <br />io~ie~2ooe weo os:zz [TX/RX No siso~ r~ooi <br />