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Oss GIFo <br />N <br />7/1/19 <br />To Whom It May <br />In accordance, <br />self -insured for <br />acting in the cc <br />official State bt. <br />presented as a <br />414, West Sect <br />The State of Cal <br />through the State <br />provides liability c <br />employees for off <br />Motor vehicle liab <br />Risk and Insurarn <br />9052, (800) 9004 <br />within six months <br />Government Clair <br />(Gov. Code sectic <br />The State of Califo <br />regarding workers' <br />Code. <br />Sincerely, <br />Navdeep Mahl <br />Associate Risk Ana <br />Insurance Services <br />Phone: (916) 376-5 <br />Fax: (916) 376-5 <br />To <br />Office of Risk and <br />707 3rd Street tar <br />DEPARTMENT OF <br />AL SERVICES Governor Gavin <br />STATE OF CALIFORNIA <br />AND WORKERS' COMPENSATION II <br />YEAR JULY 1, 2019 / JUNE 30, 2020 <br />3ov rnment Code section 11007.4, the State of California hm <br />Ity a posures. Under this form of Insurance, the State and its <br />and cope of their employment are insured for tort liability ark <br />>s. II claims against the State of California based on tort liab <br />irnm nt claim to the Government Claims Program, P.O. Box £ <br />Ito, A 9579&9052. (Gov. Code section 900, et. seq.) Inter <br />nia hi s also elected to be insured for its motor vehicle liability i <br />otor ehicle Liability Self -Insurance Program (VELSIP). This p <br />ferag P arising out of the operations of motor vehicles used by ; <br />al sta a business (California Vehicle Code Sections 17000 and <br />y clai ns against the State of California should be presented to <br />Manz gement, P.O. Box 989052 MS-403, West Sacramento, C <br />34, claimsa dos ca.cov. If your motor vehicle liability claim is n, <br />)m the date of loss. California law requires you to file a formal i <br />Pro ram, P.O. Box 989052 MS 414, West Sacramento, CA 9 <br />900, t. seq.) Internet link: <br />a Master Agreement with the State Compensation Ins <br />sation benefits for all state employees, as required by <br />/ & APPROVED <br />A gUMENT DIVISION <br />6 2019 <br />A I. LAMBERT <br />please submit to fiskmana, <br />ice mi nagement I State of California I Government Operations no <br />West Sacramento, CA 956051 t 9f6.376, 5300 f916.376.5277 <br />era <br />Reviewed by Audrey Goodso <br />to be <br />out of <br />should be <br />152 MS <br />link: <br />7001). <br />is Office of <br />95798- <br />resolved <br />iim with the <br />ice Fund <br />Labor <br />of l <br />