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A P R- 1 ~- 9 ~ T H U 1 7; ~ 7 C U M M I N G S- ~.A L E M <br />- . , ~~ CERTIFICATE OF INSUFf ANCE <br />GOMPANY: <br />• SAif Corpo+~t~on <br />Corvallis GffEce <br />1873 NW Nintt~ <br />Corvallis, OR 97330-2144 <br />INSURED: <br />Cummings r~rzving Co <br />PO Box 8rG <br />Afbany, OR 1'1321 <br />P . ~ 2 <br />THIS CERTIFICAT~~IS ISSUED AS A MATTER OF <br />INFORMATlON O`Y AND CONFERS NO RIGHTS TO TNE <br />CERTiFiCATE HO~~ER. THIS CERTI~ICATE DQ~S NOT <br />AMEND, EXTEND OR ALTER TH~ COVERAGE AFFOROED <br />BY THE POLICIES.f~ELOW. <br />7HE POLICY ~F~INSURANCE LlSTED BELOW HAS B~EN ISSU <br />FOR TH~, PG(.ICY PER100 INDICATED. THE INSURANCE AF~ <br />H~REIN I~ iIJBJECT TO ALI. THE TERMS, EXCLUSIONS AND <br />P~~.ICY~NO. <br />~_ _ 4t~3~8~ - - <br />TO THE INSURED NAMCl~ A60VE <br />DED 6Y THE P6~iCY DE~CRtRED <br />JDITIONS OF SUCH ~POLICY. ~ <br />._. _~ . - -~ = -- <br />~~-- <br />POLICY;EXP DATE ~ -= LiA6ItITY L1N4tTS ' <br />06/~0/1997 _^~__~.~in tho~s~nds)~ <br />WORK~R.S' CC~MPENSATION ~ ~ <br />07HER CpV~€~AGE AFFORQE~• ~ <br />STATUTORY <br />$100 <br />$100 <br />$500 <br />(each ar,cic~ent) <br />(each ~mploy~e} <br />(Disease. Policy) <br />. ; <br />~ <br />DESCRiP~'fO~i dF OPERA710NS/LOCAYIONSISPEClAI ITEMS; ~ <br />. <br />CANCEI~/~T10N: <br />SHOULO` ' Y OF THE A60VE DES~RIBED <br />POUCIE E CANCELE~ 6E~ORE THE <br />EXPlRATf N DATE THEREO~, THE IS$UIN~ <br />COMPAN WILL ENDEAVOR, TO MAII. 30 DI~YS' <br />WRITTEI~ ~VOTICE TO THE CERTIFICAZ E FI~LDER <br />~ NAMED Tt~ TH~ LEFt, 8UT ~AI~URE TO MAIL <br />SUCH NCSI~ICE SHALL IMPO~E NO b6L1GA710N <br />OF LIA6fLI~iY OF ANY KIND UPON Y~-tE COMPANY, <br />iTS AGEl~~S OR REPRESEN`TATIVES. <br />,. <br />CER7{FICA~~ HOLDER: <br />Housing Authnrity of the City of Saiem <br />Attn; Te~ry Frt~~er <br />PO Box 808 <br />Salem, O~ 913008-0808 <br />iCY EF~ DATE <br />07/01/1995 <br />AUT ORI~~O REPRES~NTATIVE: <br />NA~ . i <br />, t --- ._._....___ <br />issue Date (December 16, 1996) <br />