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<br />BAY CITIES JOINT POWERS INSURANCE AUTHORITY <br /> <br />MEMORANDUM OF COVERAGE <br /> <br />WORKERS' COMPENSATION COVERAGE <br /> <br />ENDORSEMENT NO.1 <br /> <br />It is understood that the named Covered Party of the Declarations is completed as follows: <br /> <br />Bay Cities Joint Powers Insurance Authority (BCJPIA); <br />City of Albany, <br />Albany Municipal Services Joint Powers Authority (AMSJPA), <br />City of Brisbane, <br />City ofEmeryville, <br />Town of Fairfax, <br />City of Larkspur, <br />Management ofEmeryville Services Authority (MESA), <br />City of Menlo Park, <br />City of Mill Valley, <br />City of Nova to, <br />City of Piedmont, <br />City of Pleasant on, <br />Pleasant on Fire, <br />Town of San Anselmo, <br />City of Sa usa lito, <br />Town ofTiburon, <br />Twin Cities Police Authority, and <br />City of Union City. <br /> <br />Attached to and forming part of Policy No. BCJPIA 2008-09 WC <br /> <br />Effective Date: July 1, 2008 <br /> <br /> <br />',::0'-:;>:.>/':,":< "-').:_>:': ?",>:> ""('>"]": , ..' (; <br />AUTHORIZED REPRESF.;NT A TIVE <br /> <br />J:\BCJPIA\AdminIDocuments\Goveming\MOC's and MPD's\2008-2009\Work CompIWCP MOC 2008-2009 [mal 050908.doc <br />Page II Effective July 1,2008 <br />