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/41~'~Ig°~ CERTIFICR0.1'E ®F LIA~IL6~'Y INSUNCE OP ID MY DATE (MM/DDIYYYY) <br /> BASIC-1 06 11/09 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> <br /> Andreini & Company-San Mateo ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> License 0208825 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 220 West 2 0th Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> San Mateo CA 94403 <br /> Phone: 650-573-1111 Fax: 650-378-4361 IN5URERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: National Union Fire ins co PA 19445 <br /> INSURER B: Everest National Insurance Co. <br /> Valle Slurry Seal Company INSURER C: State Compensation-Oregon <br /> 3785 ~hannel Drive INSURER D: <br /> West Sacramento CA 95691 <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 CONTRACT OR 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 /> LTR NSR TYPE OF INSURANCE POLICY NUMBER DATEYMMIDD/Yl E PDATE MMIDD/YY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $2000000 <br /> A X X COMMERCIAL GENERAL LIABILITY 0919520 03/01/09 03/01/10 PREMISES Eaoccurence) $100000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 1 OOOO <br /> PERSONALBADVINJURY $2000000 <br /> GENERAL AGGREGATE $ 4000000 <br /> GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $4000000 <br /> POLICY X PRO LOC <br /> JECT <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> A X ANYAU70 8263243 03/01/09 03/01/10 (Ea accident) $ 2000000 <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS <br /> BODILY INJURY $ <br /> X NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EAACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $SOOOOOO <br /> B X OCCUR ~CLAIMSMADE 7107000257091 03/01/09 03/01/10 AGGREGATE $5000000 <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND X TORY LIMITS ER <br /> C EMPLOYERS'LIABILITY 497123 -OREGON 09/01/08 09/01/09 E.L. EACH ACCIDENT $1000000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBEREXCLUDED? E.L. DISEASE-EA EMPLOYEE $ 1000000 <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT $ 1000000 <br /> OTHER <br /> DESCRIPTION OFOPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT !SPECIAL PROVISIONS <br /> RE: VSS Job#09-041; Pavement Preservation Program - 2009 Slurry Seal Project <br /> (Contract 2009-00022)(Job#4592); City of Eugene is included as additional <br /> insured for General Liability per Endts #001 and #002 attached. Primary <br /> wording applies for General Liability per Form 90533(3-06) attached. The <br /> CANCELLATION notice is amended to read 10. Days for non-payment of premium. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL C7~CMAIL 3O DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFTS L <br /> City of Eugene <br /> 99 E . Broadway, Suite 400 Pa~f~;es~laTa~I+jES: <br /> Eugene OR 97401 Au/~IQgrz~DREPRE T~ ~^r J <br /> ACORD 25 (2001/08) /,J'~/ C~'/ ©ACORD CORPORATION 1988 <br /> <br />