Resolution 299'j
'h
RLSO~UT O_I CO. 299
5 lip. n~ S. R::SOLV'r'D 9Y "FIL CITY COD.'^SL O? T!'._~'. CSTY OP
I.
6 ~ LU\G.:OOD, Fi0R1Ja, AS FGLLO::s:
7 ~ yna t^ CounetPL CCaI.nman ov
~ 1. _ . = k~c'~3'E:r o ne City o Lo~.~ro ', elori ~,
F it a:v.. tn_ C r C1er:: are hereby authorized and directed to e.._cv_e
~ (contract o: agreement) on behalf of the City .pith Th¢
LO E uit 6P¢ Li6e Aaaunance Society o6 the limited Statea
11 ~ a ooy o£ szid (contract or agzeem=_nt) being attach_d hezoto ar3
1? a__ apart hereof. _
r~
13 2_ This R_so Lutioz snail b_ o _ er.ecti va i¢-ediatel}
14 i u, .s p=_ss=_gc an_ adoption.
15 ~ pASS~D A.w An0oTdn this 6th. day of S¢pLemben
16 (A.D. 19"15_. -
17 i
13 ~ ~il~
I
h= Cit[ u. i1 0£ the
19 ~i c _ of 2,ongwood, Florida
ATT2~T:
20
r- z 1,~O_ ..~- -.
CIY^! CLEF
z,
z3 ~ .~a~
G"~[~~~\YOR a~ the City of Longi.ood,
.. ~ e'LOriaac
._FSm:
~s ~/A,J~~~/,,
?.
' /~~ -
V ct,_
z i ,.
~^ I
r.
/"' sD
.,~etaoo~,eeuo~. ~~c ~g P~=~~m,~e4~~c~oea ue,~.a I ~ ~ ~ ~
_ ~am.o~ ~c,~1,.T ~ ~e o~~em,.L,°,~"e u o ~ o ome~,N~ ~ P:°,I E°",.~,°"ate
;~.
~.~..~~~~ IIJ,S~ d,I~E~s~T, ~U~A~2~R~&~/ ~A~v,e~ ~ ~ ~ ~ ~ I
I I
c...su.. C oNAh~OO n (-i<o 2S,D A. I =~~<~^ 3,a~7~S~o
%a iii ~~e
~~`icomo+Ee i wEEK~v inoEn~Nn~v suAnrvcE Nose p,
<nro.<r=~o =
tm Fi.~o, as:: q mo~~r ~ni w~~~ a,~a m=.,m~m
e•~~n,~ ~I I~ ~I I
<,~ :~ sL~,J =a,v: ~a,:~ek~ess
^~
: ^ e.
t~~
~ <~~
_
____
e ~
e mi Mw~.~~e .p~'~~ L~J k efts to,
ei
~e
om. ~o Eq~mauau ~~.
~,i
i x ®_.
o° .,., e.en~eea. >e wee
®oe
I~~.AC°~°EN,a°o a,°~d°~s°,EMnAO~r~~~~AAN~ o~;°E. Noee roe
°E~s
a°E
"
o:m~;
;msa
~
~
,
~
~
o
o
°pe,
°p,.
j ~ o<, ®, '~a a~ o. ~ ~ o ®o° s°°a ooe s° o im„ ,,., .,
~ eea ^. ~osaaa
P~ ^ No°o.e.as.~, moo.e, ° a~do...po,~~ve,~~~aed
s~NO®
Fo, ,~„ ~pe,s,~°s4°~,.
Fo, e,~° ~~°e~e~=o,v=e.,~~.sea~°ema.memce,m~~e,
_ ems;.. °_,. o, Ee~ °,o~o P,,, s t ~ 7s
a. 'a^ P^ a°~ Gte,^ loe,<,I~°REh,ARKSSEmTIO«a°I°.~-~
s. mom==°feff,~,efe,e„~~aar~ to~eion aeriM1°EmPlo.e<,Pla°.
¢m.~~,e°fa~„~°„toe:u,e°f°~lyfmp°re~~eompe°.e~ae°. s ,f,l°,°,mnM1,a~rg.I~acate,P°=,f,=ao~aor,°..,.~I.
I .co P.fe. Emplo ee, °ta°follo .,,=a,o°.,.°°
^ m ------- _,° ro ae °.el„ aea Prem.
~~ N
°om
f3. s°oeNO~,= Re°~,nlm~r yoNomNO®
l,.ES.eomper °falEa P°`o°E E~oe~ s , ~,o~o~,on,~greo=atm°mae°®=,
Iaf P°I"~r o~ ~° f N~me,,ae
°,~.e er y nece°er°° _ _,_, .ES ~ NO ^
If veiai Namle`n c, Ym. aaiPr-rvdr~-le~l
lol c°.°„~fn c~~~~e~ev ~~ enerr.
Aoao ~re~ .e®f„ie°®P°~® ~G9
f=Iw a?~ua 3/- n5
=r w.°.P s ° c~ee coma. ~ e,~m°=e~,,.. aerema~C1
s'~ `mo ors
Is.l,fl°Il,l~~~~tye o„ a=,enepe,~eo,rp=c=le
X,>. e~° o e m°m=els=e +°pl°~pr=mom°t,~eme~ m ~_ a m ~ ,em,~mf
gGENT: Be aura to complete iM1e Supplemenxary Inf on Sect pn on bacir page.
I
EP+IPLOYER'S REQUEST FOR PARTICIPATION IN AN EQUI~GflOUP INSURANCE TgUST 1
°° P 9 cylivsl is
s°.<=~UEI.~ /~75~1ne ~~~PPOep=?m_,~.wM1~°ev~~~aCo°uneGP vCh¢~2m¢n=P I~,=•=~°
/~/ .,
~J CLZy CGenh
mp,W.. ~"__________ o r,~~.~ r....