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MPR-22-2010 10:53 From:KOFORDCHAPMANINS <br />To:5416825410 Paae:2,2 <br />D 7Y) <br />AC4fZD CERTIFICATE OF LIABILITY INSURANCE 0312212010 <br />ry PRODUCER Phone: 541.998-2383 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Koford Chapman Insurance) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />PO Box 457 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Junction City, OR 97448 ALTER THE COVERAG AFFORDED BY THE POL CIES BELOW. <br />License 801110 INSURERS AFFORDING OVERAGE NAIC # _ <br />INSURED IN$VRERA, Allied Insur nce <br />Elm's Landscape Services, Inc. <br />Keith Kokkeler INSURER B: <br />28780 JAGER LN INSURER C; <br />JUNCTION CITY, OR 97448 INSURER D: <br />INSURER E; <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE ;'OLICY'PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY UE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE S ERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLCCI?S. AGGREGATE LIMITS SHOWN MAY HAVE BEEN RED UCED BY PAID. CLAIMS, <br />INSa Apa't POLICY FFFCTIVE "DOIZCY EXPIRATI ~N LIMITS <br />TYPEOFINSORANCE POLICY NUMBER _ (~_TE IMMIDDIYY) DATE IMI/pA,pC <br />A GENERAL LIABILITY ACP 7504271778 01/01/2010 01/01/2011 FACHOCCURRENCE - $ 1.00 .000 <br />DAM/1GE TOR N D <br />COMMERCIAL 0'=NERAL LIABILITY ~+'REMISES (Ea accurnnywZ $ 1.000.000 <br />CLAIMS MADE OCCUR MED EXP An one ~gmon) $ 10,000 <br />PERSONAL RADVINJURY $ 1,000.000 <br />GENERAL AGGREGATE •000.000 <br />C•EN'LAGGREGATE LIMIT APPLIES I'ER: PRODUCTS-COMPIOPAGG s 2,000,000 <br />',X POLICY PRO LOC <br />AV-QMQDILE LIABILITY <br />COMBINED SINGLE LIMIT <br />ANY AUTO <br />(Ea aeeidef%t) <br />$ <br />ALL OWNED AUTOS <br />BODILY INJURY <br />$ <br />SCHEDULED AUTOS <br />(Per pwr on) <br />_ HIRED AUTOS <br />BODILY INJURY <br />$ <br />NON-OWN20AUTOS <br />(Peraccident) <br />_ <br />PROPERTY DAMAGE <br />$ <br />(Pgr eccldent) <br />' GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />~ ANY AUTO <br />OTHERTHAN EA ACC <br />$ <br />- <br /> <br />- AUTO <br />AUTO O <br />NLY; AGG <br />$ <br />EXCESSIUMBRELLALIABILITY <br />EACH OCCURRENCE <br />$ <br />7 OCCUR F] CLAIMS MADE <br />AGGRBGAYE <br />~ <br />EDUCTtBLE <br />$ <br />RETENTION $ <br />- <br />$ <br /> <br />T <br />WORKERS COMPENSATION AND <br />TOgy <br />L1Mazi- <br />EMFLOYERS' UABILITY <br />E.L. EACH ACCIDQNr $ <br />ANY PROPRIETORPARTNER/EXECUTIVE <br />OFF(CER1MSM3GFt EXALUOSD? <br />E,L. DISEASE - EA EMPLOYEE $ <br />SPESIFCIAL PROVI 6ATIM p USIONndgr <br />S Aglow <br />_ E.L. DISEASE • POLICY LIMIT - <br />OTHER <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS <br />Job Reference: Alton Baker Park Improvements <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DES( RIBED POLICIES BE CANCELLED BEFORE TH@ EXPIRATION <br />City of Eugene, Eng. Division, DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR To MAIL 30 DAYS WRITTEN <br />Public Works Dept. NOTICE TO THE CERTIFICATE HOl DER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />99 E Broadway IMPOSE NO OBLIGATION QR LIAF ILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Suite 400 REPRESENTATIVES. <br />Eugene, OR 97401 AUTHORIZED REPRESENTATIVE <br />I (LIZ) <br />ACORD 25 (2001108) © ACORD CORPORATION 1988 <br />Printed Uy LIZ on March 22, 2010 at 11:00AM <br />03/2212010 MON 09 58 [T},1R)f NO 58551 11002 <br />