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<br /> STATE RETIREMENT SYSTEMS FORM s
<br /> ATTACHMENT TO PROFESSIONAL SERVICES AGREEMENT
<br /> ALL SERVICE PROVIDERS MUST COMPLETE AND SIGN THIS FORM i
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<br /> '2did that Rl,areh alder ietre%ncie e.Public'Fr?p1oy s'Retiremerit Sy (PERS.),:School ',. ' ' t
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<br /> IF..TIIEBE JS. YS"•ANSX''ERTo ANY:P. OF`-:QUE$TIOINS.Zc:OFR-3,AN'ADDI'TXQ .1 ,'' 1
<br /> QUESTION V'AIR,!.(AVA)LA$i Z `ROM UR�ORLEGAL)MO T BE F1U.ED.O'iJT Ate••.'•: i
<br /> .CONTRAC, •.,• `
<br /> Servica Provide�rNsme• Yt+`i{rye!a ,
<br /> •Signa Printt;d N•ame4 E 'Ale: j V' •c' ''`• `
<br /> (Retirement Form Approved by City Attorney's Office June 15,2014)
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