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02/05/2008 14:16 15802969992 MILLtK 1M5UKHNVt rH~~ ~<«U <br />BMSL9F-AN99 f~~Qj41REKF-NTAEE~W~AT <br />TO BE COMPLETED BY APPROPR6ATE fNS9.,QRANC,E A+GENT <br />1f~QS.LB~'_69TU&.N,-"a PART 0,+~ RID <br />II the undersrgned agent, certify t,hat the ansuraro~ ~~qUireMentS conkawne'd ira thj., Iaid <br />document have been t'eviewed by rrae with 8iyo bePraw-s.der►tified <br />venc9carlconteactar)cQnsultaRtlengin~erfarchiter-t. &'6 Rh~ bePow-adenti'FAed <br />vendorlcantractorlconsultantlengineeriarc~~~~~~ awar~airl t6-i'sa ~~~retct byr the af <br />Paris, 9 e able, within ten (10) w+arkirog days afteQ° being notffiecl of sufifi~ award, to <br />furn;sh a va~id insurance cerfaficate to thc Coty meetang alI o-f T,s requareammnts containe'd <br />in #his id. <br />yk& ~~j <br />Agent's Sigrta#ure .A~gent Nai-ne (P'rint ea~ Tafipe) <br />/II0f2TflG~ UR~ urG"A <br />Name af Iisurance Carrier <br />Address of Agbncy <br />D - 910- f99D <br />S1LBSCRRBFy'U AiND S'kb'4JTtN TO bcfo.rc arie this dKs1r o.P, <br />Nonmry fiuhlqc, S-P,zGtrL af TE'%fl$ <br />- . .._u...__ <br />N2-TE_'CO. AGEN~:_-- _,..f titis Cirnc ncqdiirerneazt is u.trT rmt, tEle Ci1y 1%e ux r.ight tc.-, tjecl~sc thia Yc'n<j'~t 7nor~-Tr9110mlblrw tu7d auvaz'4 tb <br />ontra.et to the nex,t Aowest bic1der meeA,ix,.g nco snecifica.tarong. If yosa. havr anr qae:stinnr ecbnrcmi,xag t.h.e, <br />~ • d X, u _-j 1 -ti C ?;I 3 S u "1 cl !-I WdG ~ = L; PnOr -HJ qg_q <br />