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~~ C E RT I F S CAT E F L CAB E L I TY I N S U RAN C E <br /> <br />+ DATE (MM1DDfYYYYI <br />~~/a~/2aos <br />pRDDUCER <br />::(541}681-1117 FAX (541)342-8280 <br />Ward Insurance Agency, Inc. <br />P 0 Box 1~Q167 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLYAND CONFERS ND RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Eugene, aR 9144a <br />INSURERS AFFORDING OVERAGE <br />NAIL # <br />INSURED INSURER A: American States Insurance Co 19104 <br />Second Growth, Inc. INSURER B: <br />P . Q . BOX 11a8a INSURER c: <br />Eugene, aR 97440 INSURER D: <br /> INSURER E: <br />f'C1V~RAf~F.C <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 DF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED DR <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 SEEN REDUCED BY PAID CLAIMS. <br />INSR DD' <br />LTR NSR TYRE OF INSURANCE POLICY NUMBER POLfCY EFFECTIVE <br />D E MMIDDIY POLICY EXPIRATION <br />DATE MM1DD LIMITS <br /> GENERALLIABfLITY 01CG4S05545 12/a1/zoo~ ~2/a1/2aas EACH OCCURRENCE $ 1,oaa,aaa <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 2aa, aaa <br /> CLAIMS MADE a OCCUR MED EXP Any one person) $ 1a, aaa <br />A PERSONAL & ADV INJURY $ ~, , aaa , aaa <br /> GENERAL AGGREGATE $ 2 , OOO , aaa <br /> GEN'L AGGREGATE LIMITAPPLIE5 PER: PRODUCTS -COMPIOP AGG $ ~ ~ oaa ~ aaa <br /> POLICY X j~ ~ ~ LOC <br /> AUTOMDBILELIABILITY a1CG45a55'45 12/a1/2aa7 12/a1/2aa8 CDMBINEDSINGLELIMIT <br /> X ANY AUTO (Ea accident) $ <br />~ , oao , aoo <br /> ALL owNED AurOs <br />BODILY INJURY <br /> <br />SCHEDULED AUTOS <br />(Per person) ~ <br />A <br /> HIRED AUTOS BODILY INJURY <br /> <br />NDN-0WNED AUTOS <br />(Per accident) $ <br /> PROPERTY DAMAGE <br /> <br />(Per accident) $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO DTHERTHAN EAACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESSIUMI3RELLAUABILITY EACH OCCURRENCE $ ~ ~ Qaa i aaa <br /> X OCCUR ~ CLAIMS MADE a15U399245 12/aI/2001 12/a1/2aas AGGREGATE $ ~, aaa, aaa <br />A ~ <br /> DEDUCTIBLE ~ <br /> X RETENTION $ 1a, as $ <br />WORKERS CDMPE;NSATfON AND <br />' WC STATU- OTH- <br />EMPLOYERS <br />LIABILITY <br />ANY PRDPRIETORIPARTNERIEXECUTNE <br /> <br />E.L, EACH ACCIDENT <br /> <br />$ <br />DI=FICERIMEMBER EXCLUDED? £.L. DISEASE - EA EMPLOYEE $ <br />If yes, describe ender <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br />(}TREK <br />DESCRIPTION OF OPERATIaNS l LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT !SPECIAL PROVISIONS <br />E: City of Eugene fob #4512; Delta Ponds Riparian Planting <br />ertificate holder is included as Additional Insured. Coverage shall apply as Primary and <br />on-Contributory, <br />Gttillhl(~Alt H <br />City of Eugene <br />Public Works Department <br />244 East Broadway <br />Eugene, aR 914x1 <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED FOLfCIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />~a DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TD THI=LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO Dl3LIGATIaN OR LIABILITY <br />DF ANY KIND UPON THE INSURER, ITS AG)=NTS OR REPRESENTATIVES. <br />AUTWORIZED REPRESENTATIVE ~ Yy~~ <br />Charl ey o = Dell /TRUDIE ~/ <br />ACDRD 25 s1200114$j FAX: 652-5410 DACORD CORPORATION 19$8 <br />