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THIS CONTRACT IS NOT VALID UNTIL SIGNED BY ALL PARTIES <br />7 ~ ~ ~ ~ ~ j? ~~'~~ <br />Contractor's Signature ~ ~'J~ ' Dat tractor's Name (Please Print) <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 Pu~'chasin gent. <br />Attest: ~' <br />R Q atn is H e, Ci C <br />Purchasing ounty of San Mateo Date ' <br />/t_ n <br />3•y~~7 <br />Date <br />Department or Division Head Name (Please Print) Budget Unit <br />Distribution - I copy to each: Purchasing Agent, County Manager's Oftice, Controller, Contractor and Department v 6/24/04 <br />Short Form AgreemenUNon Business Associate <br />