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Page 2 7.1.A. - Page 7 <br /> Agreement with Independent Contractor <br /> NOTE: These certificates shall specify or be endorsed to provide that thirty (30) days notice must be given, <br /> in writing,to County of any pending change in the limits of liability or of any cancellation or modification <br /> of the policy. "The County and its officers, agents, servants and employees, shall be named as additional <br /> insured on any such policies of insurance..." Such statements, mentioned above,shall be included on a <br /> separate endorsement with the Certificate of Insurance before they will be accepted by the County of <br /> San Mateo. <br /> Note: Your insurance must remain in a current status <br /> throughout the life of the Agreement. Please have your <br /> insurance company send verification of renewals and/or <br /> X changes in service as they occur. <br /> Completed and signed W-9 Request for Taxpayer <br /> Identification Number and Certification <br /> Current Schedule of Fees <br /> Completed Contractor's Declaration Form <br /> Please return the completed Agreement and requested items to my attention by August 27, 2012. Once the <br /> Director of Public Works has signed the Agreement, a copy will be sent to you. <br /> If you have any questions,please call me at(650) 599-1426. <br /> Very truly yours, <br /> Oristela Guidos <br /> Contract Administrator <br /> San Mateo County <br /> Department of Public Works <br /> Enclosure: Agreement with Independent Contractor <br /> Contractor's Declaration Form <br /> cc: Ann Stillman,Deputy Director <br />