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MODIFICATION NO. 1000 <br /> TO THE WASHINGTON STATE SOCIAL SECURITY AGREEMENT <br /> The Commissioner of Social Security and the State of Washington, acting through its <br /> representative designated to administer its responsibilities under the agreement of July 31, 1951, <br /> hereby accept as an additional coverage group under said agreement, except as otherwise <br /> provided for under Section 218(n) of the Social Security Act, for Medicare HI-only coverage to <br /> the following: <br /> Entity Name: City of Everett <br /> FEIN: 91-6001248 <br /> Effective date of coverage: January 1, 2019 <br /> Number of employees: 1 <br /> Services Covered: Services performed by individuals as employees of the above named <br /> political subdivision as members of a coverage group (as defined in Section 218(d)(4) of the Act) <br /> of the retirement system, designated as Part 1 of the Law Enforcement Officers' and Fire <br /> Fighters' Retirement System, (as established by Section 218(d)(6)(c) of the Act). <br /> In accordance with Section 218(e)(2) of the Social Security Act, the State of Washington <br /> designates the following date: October 28, 2019. <br /> Approved for the State of Washington this L`T `l day of9 `1,3251 . 20 1 q . <br /> 4bYL4�1 Ply t c.' <br /> (7 . <br /> �� <br /> erly C. Smit, State `ocial Security Administrator <br /> Washington State Department of Retirement Systems <br /> Approved this '14> day of `j0 v VA j 2024). <br /> The Commissioner of Social Securi <br /> By: 44/_,/ Yg> ,,6,,,«4 <br /> Region ommissioner <br /> Social ecurity Administration <br />