Enter Basic Contract Information
Administrative Information
| Contract Manager Name (City Staff) |
Moya Marquez
|
| Contract Manager Email ([email protected]) |
[email protected]
|
| Department |
01 - CMD
|
| Division |
15 - Community & Legislative Affairs
|
Basic Contract Details
| Vendor Name |
Cedars Sinai Medical Center
|
| Vendor Number (3____ for AP and 00___ for AR) |
306102
|
| Vendor Contact Name |
Zulfikarali Surani
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
LGBTQ+ Cancer Symposium
|
| Contract / Amendment Amount |
$0.00
|
| Is this a new agreement or an amendment to an existing agreement? |
New Agreement
|
| Supplemental Insurance (for Risk team only) |
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|
Upload Contract Documents
Upload Documents
| Upload Contract or Amendment Authorization Form |
CAF - Cedars Sinai SIGNED.pdf
|
| Upload Agreement or Amendment |
Cedars Sinai - LGBTQ Cancer Symposium - City CoSponsorship Agmt SIGNED.pdf
|
| Upload Docusign "Certificate(s) of Completion" |
Cedars Cert.pdf
|
| Upload Insurance Documents (COI, Endorsements, WOS, etc.) |
The City of West Holywood AI.pdf, The City of West Hollywood WC.pdf, The City of West Hollywood GL AL.pdf
|
| Describe changes to Insurance Requirements, if any (if no insurance is required, type "None required") |
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|
| Describe changes to Contract Template, if any (If none, type "None required") |
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|
| Upload other supporting documents here, if necessary (e.g. staff reports, etc.) |
Meister_Co-sponsor Cedars LGBTQ+ Cancer Symposium.docx
|
Supplemental Risk Information
General Liability Details
| Policy Effective Date |
07/01/2021
|
| Policy Expiration Date |
07/01/2022
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
AI
|
Automobile Policy Details
| Effective Date |
07/01/2021
|
| Expiration Date |
07/01/2022
|
| Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
| Effective Date |
07/01/2021
|
| Expiration Date |
07/01/2022
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
Exempt
|
