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2022-252-E-County Mgr-Travelers Insurance-Work comp coverage
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2022-252-E-County Mgr-Travelers Insurance-Work comp coverage
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Entry Properties
Last modified
7/5/2022 10:14:29 AM
Creation date
7/5/2022 10:14:12 AM
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Template:
Contract
Date
6/30/2022
Contract Starting Date
6/30/2022
Contract Ending Date
7/1/2022
Contract Document Type
Contract
Amount
$227,358.00
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Version 10.14.19 Program Agreement - Orange County Page 11 <br />CA Form - WC 99 06 Q6 (B) <br />© (2019) The Travelers Indemnity Company. All rights reserved. <br />AGREED TO BY AND BETWEEN: <br />Orange County THE TRAVELERS INDEMNITY COMPANY <br />________________________________________________________________________________________ <br />Name: Bonnie Hammersly <br />Address: 208 SOUTH CAMERON STREET <br />HILLSBOROUGH, NC 27278 <br />BHAMMERSLEY@ORANGECOUNTYNC.GOV <br />DATE: <br />__________________________________ <br />Name: Gary Donaldson <br />Address: 208 SOUTH CAMERON STREET <br />HILLSBOROUGH, NC 27278 <br />GDONALDSON@ORANGECOUNTYNC.GOV <br />DATE: <br />Address: Travelers,385 Washington Street <br />St. Paul, MN 55102 <br />Attn: Stephanie Gardner <br />Email: SGARDNE2@travelers.com <br />DATE:6-30-2022 <br />DocuSign Envelope ID: FCD9FE56-CF01-4E96-B983-B8E8DFE6811C
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