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,4?c CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) <br /> 06/1212009 <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 INSURER B: <br /> PO BOX 7882 <br /> EUGENE OR 97401 INSURER C: <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 POLICY EXPIRATION <br /> LTR IN TYPE OF INSURANCE POLICY NUMBER DATE (MM10D/YYYI~ DAIS MM LIMITS <br /> GENERALLWBIUTY 08/3O/2008 O8/3O/2009 EACH OCCURRENCE $ 1,000,000 <br /> A X BP 1704237 <br /> x COMMERCIAL GENERAL LIABILITY PREMISES Ea occunence $ 50,000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5,000 <br /> PERSONAL 8 ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2,000,000 <br /> POLICY jE 4 LOC $ <br /> AUTOMOBILE LU\BIUTY COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea acadenq $ <br /> ALl OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> HIRED A171'OS BODILY INJURY <br /> NON-0WNEDAUTOS (Peracddent) $ <br /> PROPERTY DAMAGE $ <br /> (PeracadeM) <br /> GARAGEUABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN ~ ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND TORY <br /> LIMITS ER <br /> EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVEa E.L EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ <br /> IMa~atory in NHl <br /> (f yes, desaibe under <br /> E.L DISEASE -POLICY LIMIT $ <br /> OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES t EXCLUSIONS ADDED BY ENDORSEMENT / SPECUIL 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 EXPIRA710N <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 OBUGA710N OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGEN75 OR <br /> EUGENE OR 97401 <br /> REPRESENTATIVES. <br /> ATTN: ADAM STEEPEN AUTHORIZED REPRESENTATIVE <br /> KRISTI J POWELL ~ ~ ~ <br /> <br /> ACORD 25 (2009101) ©1988-2009 CORD COR RATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> <br />