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DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/16/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT Julie Lundy PRODUCER NAME: FAX PHONE 541-475-2215541-475-3329 Central Oregon Insurance, Inc. (A/C, No): (A/C, No, Ext): E-MAIL P. O. Box R julie@centraloregonins.com ADDRESS: Madras, OR 97741 INSURER(S) AFFORDING COVERAGENAIC # Liberty Mutual Insurance24066 INSURER A : Liberty Mutual Insurance44393 INSURED INSURER B : Liberty Mutual Insurance24074 Hard Rock Concrete Inc INSURER C : 3333 NW Elm AveSAIF Corporation INSURER D : Redmond, OR 97756-7695Liberty Mutual Insurance INSURER E : INSURER F : COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: 00000000-120349117 THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD 1,000,000 AYYBKA54581710X COMMERCIAL GENERAL LIABILITY 09/22/201709/22/2018 EACH OCCURRENCE$ DAMAGE TO RENTED 1,000,000 X CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 15,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 X POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT BYYBAW545817101,000,000 AUTOMOBILE LIABILITY 09/22/201709/22/2018$ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED X BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS NON-OWNED HIREDPROPERTY DAMAGE XX $ (Per accident) AUTOS ONLYAUTOS ONLY $ 1,000,000 CUSO54581710XX UMBRELLA LIAB 09/22/201709/22/2018 EACH OCCURRENCE$ OCCUR EXCESS LIAB CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ X PEROTH- WORKERS COMPENSATION D973434 04/01/201804/01/2019 STATUTEER AND EMPLOYERS' LIABILITY Y / N 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 500,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 500,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below E32S218903License Bond20,000 Residential 07/08/201707/08/2018 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured status, primary and noncontributory, and waiver of subrogation for City of Eugene in accordance with CG 8810 0403 Commercial General Liability Extension endorsement. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Eugene ACCORDANCE WITH THE POLICY PROVISIONS. 100 W 10th Ave Eugene, OR 97401 AUTHORIZED REPRESENTATIVE (JUL) © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD Printed by JUL on April 16, 2018 at 09:22AM