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<br />, ' <br /> <br />COUNTY OF SAN MATEO. ' <br />MEMORANDUM . <br /> <br />- It .'/!!:' í <br />. ,. .' <br /> <br />c. <br />DATE~ <br />. .. <br /> <br />CO-~-CD <br /> <br />. <br /> <br />TO: <br /> <br />Priscilla Morsel Risk Manager <br /> <br />FROM:, <br />SUBJECT: <br /> <br />CONTRACTOR NAME: Ar¿reEi'l\mt wfH, c'-h¡ of R..d=d {!¡'-/t¡. ¡a,ck.:<:od ('it'! <br />~ ~ St..Ad 'f)I s f. i c.f d.» cI ~ i Q ú..n i em ÞfJ ¡, f:1c..h Cð I "bI sf,.., 'c. f <br />DO THEY TRAVEL: )Jo ' " <br /> <br />PERCENT OF THE TIME - <br /> <br />Esther Lucas F ÄX: 802-6440; Pony: }ISA202PE; P~one: 802-6432 <br />Contract Insurance Approval <br /> <br />NUMBER OF EMPLOYEES: <br /> <br />DUTIES (SPECIFIC): Œ,;r;rd,'{ (J..HOI? Dr 7?edux,Dd C4'~:JODO' 6~VI'! Dr á:ûrlf~ <br />(!pyIMLwiJ:y ~ '<rn .1! ~V1i IfJ?/Afl n Ìd 1 tUI d I /Yl¡! ~ ¡$im if, 1m fJA1Y"f ~I <br />COVERAGE If ~ ëCJC( ~ount Approve Waive Modify <br /> <br />Comprehensive General Liability ~ <br /> <br />Motor Vehic1e Liability <br /> <br />~ <br /> <br />Professional Liability <br /> <br />. <br /> <br />Worker' 5 Compensation <br /> <br />"'+' <br /> <br />REMARKS/COMMENTS: 1w-dz¡d t<k Id 1/tVL.I~' ~ ~ ~/l.J W <br /> <br />Øùß 2txXO ~ ~~~~ <br /> <br />SIgnature g;, '1 - ()O <br /> <br />. SUBMIT TO RISK MANAGEMENT <br /> <br />FAX 363-4864 <br /> <br />PONY EPS-163 <br /> <br />.. . <br />