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979884 - WILDISH CONSTRUCTION CO -Certificate of Insurance Page 1 of 1 <br /> OREGON WORKERS' COMPENSATION ~ ¦ <br /> CERTIFICATE. OF INSURANCE <br /> t ~ r}~iryt~ai~~n <br /> MAIL TO: CERTIFICATE HOLDER: <br /> CITY OF EUGENE CITY OF EUGENE. <br /> 99 EAST BROADWAY, SUITE 400. 99 EAST BROADWAY, SUITE 400 <br /> EUGENE, OR 97401 EUGENE, OR 97401 <br /> The policy of insurance listed below has been issued to the insured- named below for the policy period indicated. The <br /> insurance afforded by the policy described herein is subject to all the terms, exclusions and conditions of such policy. <br /> POLICY NO. POLICY PERIOD ISSUE DATE <br /> 979884 10/01/2008 TO 10/01/2009 06/08/2009 <br /> INSURED: BROKER OF RECORD: <br /> WILDISH CONSTRUCTION CO WARD INSURANCE AGENCY INC <br /> PO BOX 7428 PO BOX 10167 <br /> EUGENE,-0R 97401 EUGENE, OR 97440 <br /> LIMITS OF LIABILITY: <br /> Bodily Injury by Accident $500,000each accident <br /> Bodily .Injury by Disease $500,000each employee <br /> Bodily Injury by Disease $500,000policy limit <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS: <br /> 2009 PPP: BERTELSEN ROAD FROM WEST 11TH AVENUE TO WEST 18TH AVENUE-JOB #4501; SENECA ROAD <br /> FROM ROOSEVELT BOULEVARD TO WEST 7TH AVENUE-JOB #4528; MCKINLEY STREET FROM WEST 5TH AVENUE <br /> TO WEST 11TH AVENUE-JOB #4561 <br /> IMPORTANT: <br /> The coverage described above is in effect as of the issue date of this certificate. It is subject to change at any time in the <br /> future. <br /> This certificate is issued. as a matter of information only and confers no rights to the certificate holder. This <br /> certificate does not amend, extend or alter the coverage afforded by the policies above. <br /> CANCELLATION: <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF, <br /> THE ISSUING COMPANY WILL MAIL 30 DAYS' WRITTEN NOTICE TO THE ABOVE NAMED CERTIFICATE HOLDER. <br /> AUTHORIZED REPRESENTATIVE <br /> President and CEO <br /> © SAIF CORPORATION 1400 High. St SE (Salem, OR 97312 I P: 800.285.8525 I wwwsaif.com <br /> <br /> httDS://saifonline.saif.com/Certificates/certForm.asux F/R/20~9 <br /> <br />