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• <br /> 5 <br /> ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/Dbnr) <br /> 05/24/2004 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Woodruff-Sawyer Oregon,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 1001 SW 5th Avenue,Suite 1208 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Portland,OR 97204 <br /> (503)416-7180 INSURERS AFFORDING COVERAGE <br /> INSURED INSURER A: St.Paul Fire&Marine Insurance Co. <br /> Hoffman Construction Company of Washington INSURER B: <br /> 805 SW Broadway Suite 2100 <br /> Portland OR 97205 INSURER C: <br /> INSURER D: <br /> ( INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR TYPE OF INSURANCE POLICY NUMBER DATE IMM/DDIYYI DATE(MM/DD/Y11 LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ <br /> CLAIMS MADE OCCUR MED EXP(Any one person) $ <br /> PERSONAL 8 ADV INJURY S _ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG_ S _ <br /> POLICY JECOT LOC <br /> A AUTOMOBILE LIABILITY KV08700001 6/1/2004 6/1/2005 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) $ 1,000,000 <br /> ALL OWNED AUTOS BODILY INJURY <br /> $ <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS BODILY INJURY <br /> X NON-OWNED AUTOS (Per accident) $ <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT _ S <br /> ANY AUTO EA ACC $ <br /> OTHER THAN <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY EACH OCCURRENCE S <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> $ <br /> DEDUCTIBLE S <br /> RETENTION S S <br /> WC STATU- OTH- <br /> WORKERS COMPENSATION AND TORY LIMITS ER <br /> EMPLOYERS'LIABILITY <br /> E.L.EACH ACCIDENT S <br /> E.L.DISEASE-EA EMPLOYEE S <br /> E.L DISEASE-POLICY LIMIT $ <br /> OTHER <br /> S <br /> S <br /> DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> Everett WWTP <br /> Certificate Holder and the City of Everett,Brown and Caldwell and their officers,any elected officials,employees,agents and volunteers are named as <br /> additional insureds for this project per form CA 019 attached. <br /> Operations of the named insured subject to terns and conditions of the policy. <br /> CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION 10 Day Notice for Non-Payment of Premium <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> City of Everett DATE THEREOF,THE ISSUING INSURER WILL 04 TX MAIL 45 DAYS <br /> SSyWRyITyTEEN <br /> 3200 Cedar Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,,UTi'/ULi1R�i9�D0'86'SHa <br /> Everett,WA 98201 <br /> gixxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx <br /> AUTHORIZED REPRESENTATIVE <br /> LOAN#: <br /> ACORD 25-S(7/97) ID#: O ACORD CORPORATION 1988 <br /> 14 <br />