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OREGON WORKERS' COMPENSATION <br />CERTIFICATE OF INSURANCE <br />CERTIFICATE HOLDER: <br />PUBLIC WORKS ENGINEERING <br />CITY OF EUGENE <br />99 E BROADWAY STE 400 <br />EUGENE, OR 97401 <br />ro',0010 sai F <br />corporation <br />The policy of insurance listed below has been issued to the insured named below for the policy <br />period indicated. The insurance afforded by the policy described herein is subject to all the terms, <br />exclusions and conditions of such policy. <br />POLICY NO. POLICY PERIOD ISSUE DATE <br />523102 10/01/2009 TO 10/01/2010 04/02/2010 <br />INSURED: <br />BROWN CONTRACTING INC <br />PO BOX 26439 <br />EUGENE, OR 97402 <br />Bodily Injury by Accident <br />Bodily Injury by Disease <br />Bodily Injury by Disease <br />BROKER OF RECORD: <br />UNITED INSURANCE AGENCIES LLC <br />2101 BAILEY HILL RD #B <br />EUGENE, OR 97405 <br />LIMITS OF LIABILITY: <br />$1,000,000 each accident <br />$1,000,000 each employee <br />$1,000,000 policy limit <br />DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS: <br />29th Avenue and Willamette Street Intersection Improvements <br />Job #4513 Contract # 2010-00018 <br />IMPORTANT: <br />The coverage described above is in effect as of the issue date of this certificate. It is subject to <br />change at any time in the future. <br />This certificate is issued as a matter of information only and confers no rights to the certificate holder. <br />This 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 <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL 30 DAYS- WRITTEN <br />NOTICE TO THE ABOVE NAMED CERTIFICATE HOLDER. <br />AUTHORIZED REPRESENTATIVE <br />3rgqcT,. P R'CCJA,it--- <br />President and CEO <br />© SAIF CORPORATION 1400 High St SE I Salem, OR 973121 P- 800.285.8525 1 www.saif.com <br />