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CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDMfYI~ <br /> 06/12/2009 <br /> PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br /> POWELL INSURANCE ASSOC INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> PO BOX P HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> SPRINGFIELD OR 97477 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> (541) 747-6080 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: AUSTIN MUTUAL INSURANCE COMPANY <br /> SCOTT BROWN CONSTRUCTION INC <br /> INSURER B: <br /> PO BOX 7882 <br /> INSURER C: <br /> EUGENE OR 97401 <br /> INSURER D: <br /> INSURER E: <br /> COVERAGES <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 OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <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 BEEN REDUCED BY PAID CLAIMS. <br /> INS ADD' POLICY EFFECTIVE POUCYEXPIRATION <br /> LTR IN TYPE OF INSURANCE POLICY NUMBER DATE MM DATE MM/DD/YYYY) LIMITS <br /> GENERALLIA8ILITY 08/30/2008 08/30/2009 EACH OCCURRENCE $ 1,000,000 <br /> BP 1704237 <br /> A X X COMMERCIAL GENERAL LIABILITY PREMISES Ea ~rrence $ 50,000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5,000 <br /> PERSONAL & ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEMLAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> POUCY JECOT- LOC $ <br /> AUTOMOBILE UABIUTY <br /> COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS BODILY INJURY <br /> NON-0WNEDAUTOS (Peracddent) $ <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO EA ACC $ <br /> OTHER THAN <br /> AUTO ONLY: AGG $ <br /> EXCESS /UMBRELLA l.lA81LITY EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE g <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND WC TATU- H <br /> EMPLOYERS' L.IABILITV Y / N TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE? E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED9 <br /> IMatplatory.ln NNl E.L. DISEASE - EA EMPLOYE $ <br /> (f yes, descnUe under <br /> E.L. DISEASE-POLICY LIMIT $ <br /> OTHER <br /> DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS <br /> CITY OF EUGENE AS ADDITIONAL INSURED PER FORM BP 04 51 07 02 ATTACHED <br /> JOB # 4595 FIRE STATION 8 PARKING lOT RESUFACING LOCATED AT 500 BERTNTZEN ROAD <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> CITY OF EUGENE DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> 99 E BROADWAY STE 400 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABWTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> EUGENE OR 97401 REPRESENranvES. <br /> ATTN: ADAM STEEPEN AUTHg21ZEOREPRESENTATivE <br /> KRISTI J POWELL - ~ ~ <br /> <br /> ACORD 25 (2009101) ©1988-2009 CORD COR RATION. Ail rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> <br />