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<br /> JUt~-16- 2004 13:29 RISK r·1Gf'1T. 415 363 4864 P.01/01 <br /> ---..-, ~--_.. ---------------- <br /> -- - --- -- --- -_...-- ---------- ---- <br /> -----.- - --~---------_._-- <br /> SAN MATEO COüNTY <br /> MEMORANDUM <br /> DATE: June 16) 2004 <br /> TO: Priscilla Ha.rris Morse FAX: 363-4864 PONY: BPS 163 <br /> FROM: Carla Damante FAX: 596-3478 PONY: HSA210 <br /> SUBJECT: Contract Insurance Approval <br /> The following is to be cowpltted by the department before subnñssion to Risk <br /> Management: <br /> CONTRACTOR NAME: Cìty of Redwood City) Fair Oaks Community Center <br /> DOES THE CONTRACTOR TRAVEL AS A PART OF THE CONTRACT SERVICES? No <br /> NUMBER OF E:M:PLOYEES WORKING FOR CONTRACTOR: N/ A <br /> DUTIES TO BE PERFORMED BY CONTRACTOR FOR COUNTY: The Fair Oaks <br /> Community Center pTovides information and referral, emergency assistance, and ca.se <br /> management services to County residents. <br /> The folJowing wiJI be completed by Risk Management: <br /> INSURANCE COVERAGE: Amount Approve Waive Modify <br /> Comprehensive General LiabiHty $ )m t:j 0 0 <br /> Motor Vehic1e Liability $ 0 ~ 0 <br /> Professional Liability $ 0 ~ 0 <br /> Workers' Compensation $,56.~ ~ 0 0 <br /> REMARKS/COMMENTS: <br /> U~u1ht ~ ~-{(,-otf <br /> Risk Management Signature Date <br /> TOTAL P.01 <br />