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/ , : DATE MM DD ~ ~ ,~;ri...'?: ~ ~'."`EEEEEEiEiii'i ~i~'?i:;;:ir:i?E?:?;:::':i:i~E;?;ii:i?:`:':''!`''?;:;?i•':~ii~''i'>:':i:?;!'';?;: ;i?;i:ii:iii;iiiiii ~ :iiii;'.ii ~ ii:; ~~ ::::. .::::::. ~;;:.::.;•::.:::::::::::;::::::: ~;::::::::.;:.;:.>;:.>:.;::;:.;;::;.:;:.;:.;:.::.::.: :.;:.: 10/02/98 THIS CERTIFICATE~ IS~ISSUED~AS A MATTER~OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE INSURED Prudential Insurance Company Corporate Risk Management 213 Washington St. Newark, NJ 07102 COMPANY A Self-Insured COMPANY B Travelers Indemnity of Illinois COMPANY C N/A COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, IXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ~ CO LTR 7ypE OF INSURANCE .. POUCY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY D(PIHATION DA'fE (MM/OD/Y1n LIMITS A tiEN ERALLIABILITY SELF-INSURED 07/01/98 07J01/99 GENERALAGGfiEGATE ffi 1,000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG S 1,000,000 CLAIMS MADE ~ OCCUR PERSONAL 8~ ADV INJURY $ 1,000,000 OWNER'S & CANTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 1,000,000 MED IXP (Any one person) S AUTOMOBIIE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) a HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) ~ PROPERTY DAMAGE I S GAR A6E LIA8ILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHEF THAN AUTO ONLY. EACH ACCIDENT $ AGGREGATE 3 EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLAFOFM AGGREGATE $ OTHER THAN UMBRELLA FORM $ B WORKERS COMPENSATION AND TC2JUB203T102-2-98 O7/O'I /9H O7/O'I IJJ X STATUTORY IJNIITS EMPLOYERS' LIABILITY TDRJU6136T703-0-98 EACH ACCIDENT S b,OOO,000 THE PROPRIETOR/ TIVE INCL TC2JU6218T559-4-98 DISEASE - POLICY L1MIT $ 5,000,000 PARTNERS/IXECU OFFICERS ARE: IXCL DISEASE - EACH EMPLOYEE $ 5,000,000 OTHER I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS (LIMITS MAY BE SUBJECT TO RETENTIONS) MARION COUNTY SUPPORT SERVICES ~ TTN: PEGGY MITCHELL i50 LANCASTER DR., NE ~ALEM, OR 97305 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOP, THE ISSUIN6 COMPANY WILL ENOEAVOR TO MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTCE SHALL IMPOSE NO OBLIfiATION OR UAB OF A1J~ K~Ib ~UPON : THE COMPANY, ITS A4iNTS~ OR REPR~SEN VES. fH0 ~ PRESE •