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

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

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

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Cuslomer Name Bridgeport City BOE<br />

Administrative Services Only Agreement<br />

SIGNATURES<br />

IN WITNESS WHEREOF the parties have caused this Agreement and all Exhibits and Addenda to<br />

this Agreement to be executed in duplicate and signed by their respective officers duly<br />

authorized to do<br />

so as ofthe dates given below Employer executes as the authorized representative of the Plan with<br />

respect to the Privacy Addendum to this Agreement<br />

Dated at BRIDGEPORT CITY BOE<br />

This day of By<br />

Name<br />

Its<br />

Duly Authorized<br />

Dated at Hartford Connecticut<br />

CONNECTICUT GENERAL LIFE INSURANCE<br />

COMPANY<br />

This 21st day ofMay <strong>2010</strong><br />

By<br />

Name Jessica S Sheriff<br />

Its Contractual Agreement Unit Manager<br />

Duly Authorized<br />

OS 211<strong>2010</strong><br />

20

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