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<br />ACORD <br />GERTNFICATE QF L~ DATE (MM/DDIYY) ~..~ <br />AB~LITY INSURANCE <br />,~ <br />~AG~ '{ O~' ~ 14-MAY-1997 ' <br />aAOOUCea <br />Mi 1 I i s Cor roon Corporat i on of Eugene 99228 THIS CERTIFICATE IS ISSUED AS A DAATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />P. 0. Box 1357 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />' °ne OR 97440 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />~ 68~ 2222 <br /> <br />~ COMPANIES AFFORDING COVERAGE <br /> I coMPnNVSAIF Corporation <br />Carol Lawson ~~ A <br />INSURED . __.---- .. _. _--T- . . .... . <br />~ <br />~ <br /> ~ COMPANY <br /> B <br />Staton Construction, ~f1C. ~~ COMPANY <br />29394-B Airport Rd. C <br />Eugene OR 97402 ' coMPaNv <br /> D <br />CC3VERAG£S <br />THISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTE DBELOW HAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIOD <br />INDICATED,NOTWITHSTANDINGANYREQUIREMENT,TERMO RCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURA NCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO I <br />TYPE OF INSURANCE I POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION~ <br />~ LIMITS <br />LTR ~ , DATE (MMIDD/YY) DATE (MMIDDlYY) i <br />i <br />~ <br />~ CEN ERALLIABIUTY ~~, <br />I I GENERAL AGGREGATE $ <br /> COMMERCIALGENERALLIABILITY <br />'I I PRODUCTS~CO~AP/OP AGG $ <br />I ~I CLAIMS MADE ~ OCCUR ~I ~ PERSONAL 8 ADV INJURY $ <br /> OWNER'S 8 CONTRACTOR'S PROT ~ EACH OCCURRENCE Y <br /> <br />~ <br />i <br />~ <br />FIRE DAMAGE (Any one tire) --- <br />$ <br /> l -- ----- <br />MED EXP (Any one person) -__ ._.. <br />$ <br /> AUT OMOBILE LIABILITY ~ ~ I <br />COMBWED SING~E LIMIT <br />$ <br /> ANY AUTO ~~ <br /> ALL OWNED AUTOS ~ I I BODILY INJURY g <br /> SCHEDULED AUTOS '- ' (Per person) <br />~~ <br /> HIRED AUTOS 'I ~~I BODILY INJURY q <br /> NON~OWNED AUTOS ~ I (Per accident) ~ <br />~ <br /> <br />~ -- - __-- _ ._ _. _ _ <br />~PROPERTY DAMAGE ----- - <br />g <br /> , <br />~ i <br /> GARACE LIABILITY <br />i AUTO ONLY - EA ACCIDENT <br />~ $ <br /> ANY AUTO ' OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT $ <br /> I AGGREGATE $ <br /> EXCESS LIABILITY I ~ EACH OCCURRENCE $ <br /> UMBRELLA FORM I AGGREGATE $ <br /> i <br />OTHER THAN UMBRELLA FORM , --__ <br />$ <br />A WORKERS COMPENSATION AND <br />' ~O4OG 01-OCT-1996 01-OCT-1997 N'C STAlU- OTH- <br />TORY IMITS ER <br /> EMPLOYERS <br />LIABILRY __ <br />EL EACH ACCIDENT ___ __ <br />$ ~OO,OOO <br /> THE PROPRIETOR/ INCL EL DISEASE-POLICY LIt~AIT $ 500 <br />000 <br /> PARTNERS/EXECUTIVE , <br /> <br />OFFICERS ARE <br />EXCL <br />~ - <br />EL D~SEASE-EA EMPLOYEE ___.__._ <br />S 'IOO,OOO <br /> OTHER ~ <br />~ <br />DESCRIPTION OF OPERATIONSILOCATIONS/VEHICIES/SPECIAL ITEMS <br />AIl or some Sole Proprietors, Pa rtners or Executive Officers may be excluded. <br />Re: Salem Courthouse Square Inc. Demolition <br />C~H7iFI~A'CE HC~LI]~R ;' GA3dCLLLA~'t4N <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> El(PIRATION DATE THEREOF, THE ISSUINC COMPANY WILL ENDEAVOR TO MAIL <br /> 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />Mar i on COUfItY BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIAB~RY <br />100 High Street N.E. oF ANY KIND UPON THE COMPANY, RS ACENTS OR REPRESENTATIVES. <br />Salem OR 97301 AUTHORIZE REPRESENTA E <br />I <br />~+~C~[~ z5•5 11~~ wG~1L~ > <br />t~3~GQnrs GU~ronRrip~ i~s9 <br />