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. . . . . . . . . . . . . . . .~. . . ... . ._. . . . . .., . .....~. . ... . .:. . ::: A~_o_Rr~ ::~E~~~~~:C~:.: .~:::::~:F:: . .. . . . . . . . .... . . . . . .:.~. . . ... . .:... . . . .~. . . . .~. . . . . . . . . ~ _.~: ~~: ~~~ : ~~~ : : :~:~: :~:~:~:~:~: :~:~: :~: :~:~:~: .~. ~ . . I D~:~ >?:~::::>: :~~~B~:~:~~~'`~:::~:~I:~:EJ:.. ..:I~~:~~~n~....... ~0~~2 8 :~ ~............ . . . . . . . . . . . . . . . ......................... ............... ... ..... ..... ................................ . ........ . . . . . . . . . . . . . . . _ . . . . . . . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Great Northern Underwriters HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1600 SW 4th Ave ., Suite 900 Portland OR 97201 COMPANIES AFFORDING COVERAGE COMPANY A Fairmont Insurance Com~any PhoneNo. 503-273-5672 F~No.503-273-9224 INSURED COMPANY B Barker Surveying COMPANY A/, '~~ r~, Mr. Clarence Barker C ~~ 2036 25th 3treet SE cc~i( v Salem OR 97302 ~O ;;i,; , '9 . . . . . . :~:• •.~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~:~ :::::::::::::::::::::::::::::::::::: ~~Cf3:V~RAG~S:::::: :;:`;.'•::>:~:~:~::~:~»>:<~:~: :~:~:<~:~:~»:~:~:~>:~: »:~:~:~:~: »:~::~:~: :~: >:~:~:~:~:~: : :~:::::::.::.• •: .~:;'::'::;'::::::::': .. ...................................................... . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSU ~SURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRA TjiER DOCUMENT WITH RESPECT TO WHICH THIS THSTANDING ANY REQUIREMENT , INDICATED, NOTWI CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANC E AFFORDED BY THE POLICIES SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR 7ypE OF INSURANCE POLICY NUMBER ~LICY EFFECTIVE DATE{~NM/DD/YY} POLICY EXPIRATION DATfi {MM/DD/`(Y) LIMRS GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ CLAIMS MADE ~ OCCUR PERSONAL 8 ADV INJURY $ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) S MED EXP (Any one person) $ AUTOMOBILE LIABILIN COMBINED SINGLE LIMR $ ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY a (Per accident) NON-OWNED AUTOS PROPERN DAMAGE S GARAGE LIABILffY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIOENT S AGGREGATE E EXCESS LIABILRV EACH OCCURRENCE S UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM s ~ R ORY L R ' ' ~ ' ~ ~ ~ '~~ ~ ' ' ' WORKERS COMPENSATION AND S E M X T ................... :~ ~M°LOYERS L1A8l~IN EL EACH ACCIDENT S ZOUOOO X THEPROPRIEfOR/ INCL 80029054 04/O1/98 04/O1/99 ELDISEASE-POLICYLIMIT S 50~~00 PARTNERS/EXECUTIVE OFFICERS ARE: X IXC~ EL DISEASE- EA EMPLOYEE $ ZOOOOO OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS :E~RTtF.I£;4TE:IiOLDEFi ::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::: : :~ :::::::::::~:~:~:~: :~:~: . . :~CANCELL•;4T(QN :::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::: : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MARCOZL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1 O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Marion COL1rit17 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILIIY Elyn Lyon 1~ ~ High 3treet NE , Room 5321 - OF ANY KIND UPON THE NY, RS AGF~ffS OR TI S31P.I6 OR 97301 AUTHORIZEDREPRESE V ..... ... ...... .~4G~ftb:25-8. .119a :~:~:~: :~:~:~:~: :~:~:~:~:~:~:~:~:~: :~: :~:~: :~:~:~: : :~: : :~: :~: : : :~:~: .... .... . . .. . f. .. .).. . . ..... . ....... . . . . . .... . . . . . . .. . . . . . . . : :~:~:~:~:~:~: :~:~: : : : . . ... . . . . . . . ... ...... ......... . : ~:''::~kG`~ R. . .Oftf?ORi4'1'lOlsl:7988:::: :~: :~:~: : : : : :~: :~: :~:~:~:~:~: :•.•:~:~:~:•:•:•:~:.. .... . . .. . . . .. . . . . . . . ... . ~~~~ ~~~ ~~~ ~ ~~