GJN4671 Kipco Contract - Laserfiche WebLink

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AC4RD CERTIFICATE OF LIABILITY INSURANCE 5ii2/2oio') . PRODUCER (541) 687-1117 FAX: (541) 342-8280 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ward Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 10167 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Eugene OR 97440 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A:- Liberty Northwest Iris Kipco Inc. INSURER B: 90465 Woodruff INSURER C: INSURER D: Eugene OR 97402 INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES GG G E LIMITS SHOWN MAY EN EDUCED B ID CLAIMS, INSR LTR ADD'L INS RD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence) $ 100 , 000 A CLAIMS MADE a OCCUR C09 160647 8/10/2009 8/10/2010 MEDEXP An one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X JPEO LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,0001000 X ANY AUTO (Ea accident) A ALL OWNED AUTOS C09 160647 8/10/2009 8/10/2010 BODILYINJURY SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN ACC $ AUTO ONLY AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 4,000,000 X OCCUR FICLAIMS MADE AGGREGATE $ 4,000,000 A DEDUCTIBLE C09 160647 8/10/2009 8/10/2010 $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TH- TORSTATUS O ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? d ib If d E.L. DISEASE - EA EMPLOYEE $ yes, escr e un er SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ A OTHER INSTALLATION C09 160647 8/10/2009 8/10/2010 LIMIT: $100,000 FLOATER DEDUCTIBLE: $1,000 ALL RISKS DESCRIPTION OF OPERATIONSILOCATIONSfVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: 2010 STORMWATER REHABILITATION ON 15TH AVE FROM AGATE ST TO MOSS STREET AND AT THE INTERSECTION OF 17TH AVE AND VILLARD STREET CERTIFICATE HOLDER IS ADDED AS ADDITIONAL INSURED (PER LGL4032) ; THIS INSURANCE IS PRIMARY AND NON-CONTRIBUTORY IF REQUIRED BY WRITTEN CONTRACT AS RESPECTS TO THE WORK BEING PERFORMED BY THE INSURED ON THIS PROJECT IN ACCORDANCE WITH THE POLICY TERMS AND CONDITIONS vcr~ ~ rrwr~ ~ ~ nvw~rc CITY OF EUGENE 99 E BROADWAY SUITE 400 EUGENE, OR 97401 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE AUTHORIZED REPRESENTATIVE Rob Harvey/CARSON AL,UKU LD (LUU"1/US) INS026 (0108).08a © ACORD CORPORATION 1988 Page 1 of 2