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<br />THIS CONTRACT IS NOT VALID UNTIL SIGNED BY ALL PARTIES <br /> <br />con_wc'~~ Adu&~ <br /> <br />"'$lJlh( <br />Date ! <br /> <br />L'o hE~Tr <br />Contractor's Name (Please Print) <br /> <br />I hereby certify that the services requested are necessary, that the selection process documentation is accurate, that all insurance certificates <br />including Worker's Compensation are on file in this office, that Risk Management has approved any reductions in Contractor's insurance <br />limits below $1,000,000, and that no work will commence until this document is signed by the County Purchasing Agent. <br /> <br />, <br /> <br />df . U, ok, <br /> <br />Date <br /> <br />q-/~/o~ <br /> <br />Date ' <br /> <br />~ <br />I -" <br /> <br />I ~'!t ~~ ~~'-~ <br />Attest - <br />p Howe, City Clerk <br /> <br /> <br />~/~ t:M~ <br /> <br />Department or Division Head Name (Please Print) <br /> <br />Budget Unit <br /> <br />Distribution - 1 copy to each: Purchasing Agent, County Manager's Office, Controller, Contractor and Department <br />Short Form Agreement/Non Business Associate <br /> <br />v 6/24/04 <br /> <br />3 <br />