ISSUED BY

DELIVERY ADDRESS

BILLING ADDRESS

IMPORTANT

The BPO Number listed above must appear on all invoices, pkgs., packing slips, bills of lading and any correspondence.

The City of Largo

Office of Management and Budget

(727) 587-6727

City of Largo

Personnel

P.O. Box 296

Largo, FL 33779-0296

City of Largo

Finance Division

Accounts Payable

PO Box 296

Largo, FL 33779-0296

Buyer:

Joan Wheaton

Effective Date

10/1/99

Vendor Number

3365

VENDOR NOTICE

This Blanket Purchase Order should not be filled upon receipt. This order serves to establish future requirements. All purchases against this order must be in accordance with its terms and conditions. Any individual ordering must present a valid City I.D. card and must sign the delivery copy indicating receipt. All purchases must be documented in writing, unless other-wise indicated or agreed upon. Please contact the buyer listed above if you have any questions.

State Sales Tax Exemption

Certificate No.: 62-08-134901-54C

Expiration Date

9/30/2000

Vendor Contact

Tia Dillow

Commission App.

7/6/99

Vendor Phone

813-882-7669

Dept. Ordering

MS-Personnel

Quote Method

RFP 99-P-611

V

E

Blue Cross Blue Shield of Florida

P.O. Box 2458

Jacksonville, FL 32231-0047

N

D

O

R

QUANTITY

UNIT

DESCRIPTION

UNIT COST

TOTAL

Health Insurance for City Employees

City Retirees

Cobra Participants

FY 2000

$1,933,000.00

TOTAL (NET)

$1,933,000.00