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SAIF Corporation 4/15/2005 4:00 <br />EBEFCORPORATM <br />400 High St SE <br />Salem, OR 97312-1000 <br />Toll Free 1-800-285-8525 <br />CERTIFICATE HOLDER: <br />CITY OF EUGENE <br />PUBLIC WORKS MAINT ATTN: WEBB <br />1820 ROOSEVELT <br />EUGENE, OR 97402 <br />PAGE 1/1 SAIF Corporation <br />OREGON WORKERS' COMPENSATION <br />CERTIFICATE OF I INSURANCE <br />REVIEWco ~ y <br />r U <br />ISKWR <br />ADA %rEc <br />The policy of insurance listed below has been issued to the insured named below for <br />the policy period indicated. The insurance afforded by the policy described herein is <br />subject to all the terms, exclusions and conditions of such policy. _ <br />POLICY NO. POLICY PERIOD ISSUE DATE <br />974648 03/10/2005 TO 04/01/2006 1 04/15/2005 <br />INSURED: BROKER OF RECORD: <br />CROCKETTS INTERSTATE TOWING & <br />TRANSPORT INC <br />PO BOX 11341 <br />EUGENE, OR 97440 <br />LIMITS OF LIABILITY: <br />Bodily Injury by Accident $500,000 each accident <br />Bodily Injury by Disease $500,000 each employee <br />Bodily Injury by Disease $500,000 policy, limit <br />DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS: <br />Contract # 2005-00407 <br />IMPORTANT: <br />The coverage described above is in effect as of the issue'date of this certificate. It is <br />subject to change at any time in the future. <br />This certificate is issued as a matter of information only and confers no rights to the <br />certificate holder. This certificate does not amend, extend or alter the coverage <br />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 />0.0 <br />