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acoRO CERTIFICATE OF LIABILITY ~NSI~RANCE OP/DMA GATE (MM/DD/YYYY) <br /> MOWATOI 07/14/09 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Hub International Northwest HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P. O. Box 3018 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Bothell WA 98041-3018 <br /> Phone: 425-489-4500 Fax: 425-489-4501 INSURERS AFFORDING COVERAGE NAIL # <br /> INSURED INSURER A: Travelers Indemnity Co. <br /> wsuRERe: SAIF Corporation <br /> Mowat Construction Company INSURER C: <br /> P.O. BOX 1330 INSURER D: <br /> •I Woodinville WA 98072 <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 MAV RE ISSUED OR <br /> I <br /> MAY PERTAIN, THE INSURANCE AFFORDED BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> ~ POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS. - <br /> INSR DD'L POLICY EFFECTIVE POLICY E%PIRATION <br /> LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS <br /> I <br /> GENERAL LIABILITY - EACH OCCURRENCE 5 lOOOOOO <br /> DAMAGE TO RENTED § 300000 <br /> A X COMMERCIAL GENERAL LIABILITV xe-co-52608190-TIL-OB 12/O1/O8 12/O1/O9 PREMISES (Ea occurence) <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) 5 SOOO <br /> <br /> :-I ~ PERSONAL&ADV INJURY 5 lOOO OOO <br /> GENERAL AGGREGATE 5 2000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG § 2000000 <br /> POLICY X PRO LOC Emp Ben. 2000000 <br /> JECT <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT $ 1,000,000 <br /> A X gNVquro DT-810526D8190-TIL-OB 12/01/08 12/01/09 (Eaac~itlem) <br /> ALL OW NED AUTOS <br /> BODILY INJURY <br /> SCHEDULED AUTOS (Per person) 5 <br /> HIRED AUTOS <br /> BODILY INJURY <br /> NON-OWNED AUTOS (Per accitlent) § <br /> ' PROPERTY DAMAGE $ <br /> - (Per aaitlenl) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S <br /> ANV AUTO <br /> OTHER THAN EA ACC § <br /> AUTO ONLY: qGG $ <br /> EXCESSIUMBRELLA LIABILITV EFCH OCCURRENCE $ <br /> OCCUR ? CLAIMS MADE AGGREGATE 5 <br /> b <br /> i <br /> DEDUCTIBLE <br /> S <br /> ' RETENTION § § <br /> WORKERS COMPENSATION AND X WC STATU- OTH- <br /> TORY LIMITS ER <br /> EMPLOYERS' LIABILITY <br /> B 486151 10/01/08 10/01/09 E.L. EACH ACCIDENT 51000000 <br /> ANV PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED4 N/A TO ADD INSURED E.L. DISEASE-EA EMPLOYEE $ lOOOOOO <br /> If yes, desIXibe under <br /> .SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT § /DODO OO <br /> OTHER <br /> DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> ADDITIONAL INSURED (S) AS REQUIRED BY WRITTEN CONTRACT SUBJECT TO POLICY <br /> TERMS, CONDITIONS, LIMITATIONS & ATTACHED ENDORSEMENT: SEE ATTACHED HOLDERE <br /> NOTES <br /> RE: DELTA PONDS PATH, GOOD PASTURE ISLAND ROAD TO ROBIN HOOD AVENUE, JOB <br /> #4378 BID NUMBER 20, FED. PROJ. #X-HPP-TEA-2385 (060) <br /> CERTIFICATE HOLDER CANCELLATION <br /> CIEUGEN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E%PIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN <br /> CITY OF EUGENE NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> PUBLIC WORKS DEPARTMENT <br /> ' IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> 99 EAST BROADWAY, #400 <br /> EUGENE OR 97401 REPRESENTATIVES. <br /> AUT RIZEO ftEPRE ENTATIVE <br /> ACORD 25 (2001!08) ©ACORD CORPORATION 1988 <br /> _ _ _ <br /> <br />