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MAR-23-2010 14:28 From:ICOFORDCHAPMANINS <br />To:5416828410 Pase:2.2 <br />ACORDCERTIFICATE OF LIABILITY INSURANCE I D03/23/20 01 <br />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 />BOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Junction 4 ALTER, THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br />unction City, OR 97448 <br />License 801110 INSURERS A1=FORDING COVERAGE NAIC # <br />INSUMD INsURERA; Allied Insurance <br />Elrn's Landscape Services, Inc. INSURER s: Aus in M ,tual <br />Keith Kokkeler <br />INSURER 0: <br />28780 JAGER l..N <br />wsuRE<JUNCTION CITY, OR 97448 D: <br />[NSVRER 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 SY PAID CLAIMS, <br />INSR ADD' LIC EFFECT" POLICY EXPIRATION <br />PO <br />~jg, NCR TYPE OF INSURANCE _ POLICY NUMBER r PATEY IMMft U-0 -PATE IMM/D IYYI 41M175 <br />A 'GENERAL LIABILITY ACP 7504271778 0110112010 01/01/2011 EACHOCCURRENCE $ 1.000,Q00_ <br />ccvrr~nu.?1_ $ 1.000.000 <br />_ COMMERCIAL GENERAL LIABILITY p FR[,S~ES,(Ea oENT.u <br />CLAIMS MADE OCCUR MED EXP (Any ono pe ,on -L-11 A000 <br />PERSONAL S ADV INJURY $ 1,000.000 <br />GENERALAGGREGATE 'S 2,000,000 <br />GEN'LAGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OPAGG' S 2,000,000 <br />' POLICY F71 pjpgc'~' El LOC <br />_ ^ <br />B AUTOMOSILEtJAWLITY BA 1922418 <br />0110112010 01/01/2011 COMEtINEDSINGLEUMrc <br />S <br />(Ea accident) <br />000 <br />000 <br />1 <br />ANY AUTO <br />. <br />. <br />ALL OWNED AVTO$ <br />BODILY INJURY $ <br />X SCHSOULEDAUTOS <br />(Per person) <br /> <br />X HIRED AUTOS <br />BODILY INJURY <br />X NON-OWNED AUTOS <br />(Pqr accident) <br />X Como Ded $500 <br />PROPERTY DAMAGE $ <br />x` CQII ped !UFO <br />(Peraccfdent) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT $ <br />ANY AUTO <br />OTHER THAN EA ACC--/ $ <br />- <br /> <br />AUTO ONLY AGG ' S <br />EXCESSIVMERELLALIABILITY ~ <br />EACH OCCURRENCE S' <br />OCCUR CLAIMS MADE <br />AGGREGATE $ _ <br />~ <br />OEOUCTIgLE <br />S <br />RETENTION $ <br />$ <br /> <br />WC STATU. OTN• <br />WORKERS COMPENSATION AND <br />ORYJ.WLELS R.~ <br />EMPLOYERS' LIABILITY <br />151, EACH ACCIDENT $ <br />ANY PROPRIETOR/PARTNER/PXECUTIVE <br />QFFICERIMFMBER EXCLUDED7 <br />E.L. DISEASE - EA EMPLOYEE $ <br />lire.',. dBSalbe Under <br />_ SPECIAL PROVISIONS tnlrnv__ <br />_ El, DISEASE - POLICY LIMIT 5 <br />OTHER <br />DESURIPTION OF OPERATION.' / LOCATIONS I VEHIGi..ES I EXCLUSIONS ADDEb BY ENDORSEMENT I SPECIAL PROVISIONS <br />Job Referenco: Alton Baker Park, Improvements <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POUC19S BE CANCELLED BEFORE THE EXPIRATION <br />City of Eugene, Eng. Division, DATE THEREOF, THE ISSUINO INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRIYTEN <br />Public Works Dept. NOTICE To THE CERTIFICATE HOLDER NAMED TO THE LEFT, @UT FAILURE TO DO SO SHALL <br />99 E Broadway IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Suite 400 REPRESENTATIVFS, <br />Eugene, OR 97401 AUTHORIZRD REPRESENTATIVE <br />ACORD 25 (2001108) ©ACORD CORPORATION 1988 <br />Printed by LIZ on March 23, 2010 at 02:38PM <br />03/23/2010 T U E 13 31 ET},/RX N0 5 859] 12 002 <br />