Enter Basic Contract Information
Administrative Information
Basic Contract Details
| Vendor Name |
Monjaras & Wismeyer Group (dba Return to Work Partners)
|
| Vendor Number (3____ for AP and 00___ for AR) |
329993
|
| Vendor Contact Name |
Julie Varela
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Return to Work Partners (R2WP)
|
| Contract / Amendment Amount |
$15,000.00
|
| Is this a new agreement or an amendment to an existing agreement? |
New Agreement
|
| Supplemental Insurance (for Risk team only) |
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|
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Supplemental Risk Information
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General Liability Details
| Policy Effective Date |
08/29/2022
|
| Policy Expiration Date |
08/09/2023
|
| Policy Amount |
$2,000,000.00
|
| Endorsements |
PNC, AI, WOS
|
| Waived |
waiting on WOS
|
Automobile Policy Details
| Effective Date |
08/29/2022
|
| Expiration Date |
08/29/2023
|
| Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
| Effective Date |
08/29/2022
|
| Expiration Date |
08/29/2023
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
WOS
|
| Waived |
WOS pending
|
Professional Liability Policy Details
| Effective Date |
08/29/2022
|
| Expiration Date |
08/29/2023
|
| Policy Amount |
$1,000,000.00
|
