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Page 2 <br />Agreement with Independent Contractor <br />NOTE: These certificates shall specify or be endorsed to provide that thirty (30) days notice must be given, <br />in writing, to County of any pending change in the limits of liability or of any cancellation or modification <br />of the policy. "The County and its officers, agents, servants and employees, shall be named as additional <br />insured on any such policies of insurance..." Such statements. mentioned above. shall be included on a <br />separate endorsement with the Certificate of Insurance before they will be accepted by the County of <br />San Mateo. <br />Note: Your insurance must remain in a current status <br />throughout the life of the Agreement. Please have your <br />insurance company send verification of renewals and/or <br />X changes in service as they occur. <br />Completed and signed W-9 Request for Taxpayer <br />Identification Number and Certification <br />Current Schedule of Fees <br />Please return the completed Agreement and requested items to my attention within ten (10) working days. <br />Once the Director of Public Works has signed the Agreement, a copy will be sent to you. <br />If you have any questions, please call me at (650) 599-1426. <br />Very truly yours, <br />Contract Administrator <br />San Mateo County <br />Department of Public Works <br />Enclosure: Agreement with Independent Contractor <br />cc: Ann Stillman, Deputy Director <br />REV: 09-04-14 MLG <br /> <br /> <br /> <br />ATTY/AGR/2014.163/COUNTY OF SAN MATEO <br />7.1.B. - Page 4