ORDER N0. 16964
APPROVAL OF PAYMENT TO CARLOS RIVERA, JR. FOR LABOR
& MATERIALS FOR RENOVATION AND ALTERATIONS TO THE
JUVENILE DETENTION CENTER
On this the 8th day of December 1986, upon motion made
by Commissioner Higgins, seconded by Commissioner Holland,
the Court unanimously approved payment to CARLOS RIVERA, JR.,
in the amount of $840.00 for labor and materials for renova-
tion and alterations to the Juvenile Detention Center, as
recommended by Michael Pleal Walker, Architect.
(Scrape & sand all loose paint on walls, bars, floors,
steel bunkbeds, metal doors, spot prime and paint solid
with prime where needed, etc. as shown on invoice.)
It is ordered by the Court that the County Treasurer and
County Auditor be authorized to draw a voucher on the Revenue
Sharing Trust Fund, payable to CARLOS RIVERA, JR., in the
above amount.
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INSURER: Twin City Tire Insurance Company
~ THE HARTFORD co. code
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(Previous Policy No.:'
Items l
1. Named Insured and Mailing Address ~
(No., Street, Town, County, State) p
Partnershr ~ Otheora6on
Other workplaces nolshown shove:

CUV 14 1986 ~~
POLICY N0. 71 WZ CF1475
Carlos Rivera, Jr. dba
Carlos Rivera Painting Co.
Rt. 2, Box 109-A
Fredericksburg, Texas 78624
flenewai
2. The Policy Period is Irom R-9-86 to B-e-R7 42:41 A.M., standard time at the_{DSered's mailing address
rProducer's Name Producer's Code
}till Country Insurance Agency 213474
Drawer 192 ~
Fredericksburg, Texas 78624 _~ /
3. A. Workers' Compensation Insurance: Part One of the policy applies to the Workers' Compensation Law of the states listed here: Texas
B. Employers' Liahility Insurance: Part Two of the policy applies to work in each stale listed in Item 3A.
The Limits of our Liability under Part Two are: Bodily Injury by Accident $100,D00. Each accident
Bodily Injury by Disease $ 540_,_0120. Policy Limit
Bodily Injury by Disease $ _100y ooo. each employee
C. Other Stales Insurance: Part Three of the policy applies to the states, if any, listed here: NONE
D. This policy includes these endorsements and schedules: 1JC 42 03 O1, 47C 77 00 00, WC 00 02 02
4. The premium for this policy will be determined by our manuals of Rules, Classifications, Roles and Rating Plans.
All Intormatien required below is subiecl to verification and choose by audit.


Classilications	
Code
Numher	Premium Basis

TolalEstimaled
Annual Remuneration	Rale Per

$100ot
Remuneration	
Eslimaled Annual
premium
Painting or Paper hanging NOC & Drivers	5474	10,000.	7.73	773.
	..			
Expense Constant	0900			85.
Inlerslale~lnirastale ID No.				
Total Eslimaled Standard Premium $ 858.
Minimum Premium: $ 366. Deposit Premium $ 868.
AudilPeriod: ^ Annual ~] Semi Annual ^ Quarterly ^ Monthly 9-10-86 mw
r
Countersigned by
Form WC 00 00 01 (Ed. 04-e4) Printed in U.S.A. nutnorized Agent
R-1
ORDER NO. 16964
APPROVAL OF Pb1YIiiF.NT TO
CARLOS RIVERA, JR., FOR LABOR
& P~IATERIALS FOR REPIOVAT30tI AND
ALTERATIONS TO THE JUVENILE
DETENTION CENTER
12-3-86
VOL. _~, Page -~