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y ~~~ <br />;% ~ <br />,~,~~,', <br />0 <br />0 <br />~ <br />~ <br />~ <br />~ <br />~ <br />o~ ~ <br />Sedgwick o~ Oregon. Inc. <br />111 SW Columbia <br />Portland, C!R 97201 <br />~~~~o~~~ <br />MAR 2 2 1999 <br />MARIpN G4UN~' ~UPPORT <br />S~RVICES DEPARTMENT <br />Marion County 5alem Area <br />Mass Transit <br />3150 Lancaster Dr NE <br />Salem. OR 97305-1389 <br />INVOICE NO. <br />~;~~ PAGE INVOICE DATE <br />1 OF 3/16/99 593b7B <br />Sedgwick - <br />CUSTOMER NO. ACCOUNT EXECUTIVE <br />MA269:L71 145 L I LLY R <br />PRODUCER <br />14~ LILLY R <br />REMIT TO: <br />Sedgwick of Oregon, Inc. <br />Portland Department 409 <br />p, p. Box 34935 <br />Seattle, WA 98124-1935 <br />503-248-6400 <br />POLICY TYPE <br />INSURANCE COMPANY <br />M~ryland Casualty ' Builders Risk <br />NAME INSURED POLICY NUMBER EFFECTIVE DATE <br />Marion County Salem Area ' ECA055829924 3/OS/99 <br />-. <br />Huildera~ Ri~k ` <br />POR# Soannetl <br />' Sudget# <br />Object# <br />R~ojed# <br />Date RTP Date RTF <br />Approver's Initials <br />'lease pay from ~his invoice. Sta emen <br />lvngeT be sent unless requested. Thank yo~. <br />!D1l01 <br />36, 808. 00 <br />accoun~ will no <br />36- 808. 00 ~ ~, <br />TERMS~. PREMIUMS ARE DUE AS OF THE TRANSACTION EFFEGTIVE DATE OR TOTAL - I <br />uPON RECEiPT oF THis iNVOicE CUSTOMER COPY AMOUNT <br />