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2010-06-07_(2).pdf - 19318.8K - BridgeportCT.gov

2010-06-07_(2).pdf - 19318.8K - BridgeportCT.gov

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IN VIEW OF THE FOREGOING We the undersigned hereby unite in requesting the<br />

Compensation Commissioner for the 4th District to make an award by stipulation<br />

pursuant to this Agreement<br />

IN WITNESS WHEREOF We have hereunto set our hands and seals<br />

WITNESS<br />

CHARLES FEREIRA<br />

CLAIMANT<br />

DATE<br />

CHRISTOPHER B CARVETH ESQ DATE<br />

CLAIMANT S ATTORNEY<br />

TAXPAYER 10 NUMBER <strong>06</strong> 0968297<br />

CITY OF BRiDGEPORT FIRE DEPARTMENT<br />

EMPLOYER RESPONDENT<br />

AND<br />

CITY OF BRIDGEPORT FIRE DEPARTMENT<br />

THIRD PARTY ADMINISTRATOR<br />

RESPONDENT<br />

FRANK A MAY ESQ<br />

RESPONDENTS ATTORNEY<br />

DATE<br />

7<br />

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