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<br />COUNTY OF SAN MATEO <br />MEMORANDUM <br /> <br />DATE: <br /> <br />S -5-qq <br /> <br />TO: <br /> <br />Priscilla Morse, Risk Manager <br /> <br />FROM: <br /> <br />Esther Lucas FAX: 802-6440; Pony: HSA202PE; Phone: 802-6432 <br /> <br />SUBJECT: <br />CONTRACTOR NAME: Ag~.~1t. &fz.L:ð!.n ~ J!Á1fJtYl(iÍLb (f.lru Iii <br />/2t.d/[(VÐ LY'Hf arlit &clvXXJJ; (lfn¡ ,-C£I!óOL 7dts"fþcr L) <br />DO THEY TRAVEL: nO <br /> <br />Contract Insurance Approval <br /> <br />PERCENT OF THE TIME - <br /> <br />NUMBER OF EMPLOYEES: <br /> <br />DUTIES (S PEe IF I q: 5<LfJIJ!'L1: . H £uØ.ð') {J d{ (I ~ ~ /lù.ut MTlIJó:'tk..-. <br />( C:.-b6ýtfuU;l1'(..~Cå\(.P a d:"/¿U-Æ ¿.ØY"â:i'ü if... XJt~)aj- sc.:Øut)DJc&tt~:-t..t.:t~-4-J <br />COVERAGE - R/)JC~lt.f;ú/ Disr Amount Approve Waive Modify <br /> <br />Motor Vehicle Liability <br /> <br />/ lr()() tOt) <br /> I <br /> <br />'I <br />L <br /> <br />Comprehensive General Liability <br /> <br />I, tOo, 000 <br />, , <br /> <br />Professional Liability <br /> <br />~ <br /> <br />Worker's Compensation <br /> <br />311. 1JliN 1 L <br />REMARKS/COM:MENTS' U . . <br /><12 . k.t tLð¡1liYVlfil-r pu.:flt..u<.4' ~túdj! kfd NUftLa,~~ <br />tu.L ~r'" lJ¿uxu~ iJ-UL ~ l' ~~ <br /> <br />Signature <br /> <br />".¿ <br /> <br />SUBMIT TO RISK MANAGEMENT <br /> <br />FAX 363-4864 <br /> <br />PONY EPS-163 <br /> <br />'; . <br /> <br />RISK MANAGEMENT <br />MAY 06 1999 <br />P. MORSE <br /> <br />"'---'-""--'T'...-m' <br />