Enter Basic Contract Information
Administrative Information
Basic Contract Details
Vendor Name |
JVS SoCal
|
Vendor Number (3____ for AP and 00___ for AR) |
303455
|
Vendor Contact Name |
Alan Levey
|
Vendor Contact Email |
[email protected]
|
Contract / Amendment Title |
Contract for employment services
|
Contract / Amendment Amount |
$158,692.00
|
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 |
Contract Auth.pdf
|
Upload Agreement or Amendment |
JVS Contract.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.) |
JVS Scope.pdf, JVS Budget.pdf
|
Supplemental Risk Information
General Liability Details
Policy Effective Date |
11/01/2021
|
Policy Expiration Date |
11/01/2022
|
Policy Amount |
$1,000,000.00
|
Endorsements |
PNC, AI, WOS
|
Waived |
includes sex abuse/molestation
|
Automobile Policy Details
Effective Date |
11/01/2021
|
Expiration Date |
11/01/2022
|
Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
Effective Date |
01/01/2022
|
Expiration Date |
01/01/2023
|
Policy Amount |
$1,000,000.00
|
Endorsements |
WOS
|
Professional Liability Policy Details
Effective Date |
11/01/2021
|
Expiration Date |
11/01/2022
|
Policy Amount |
$1,000,000.00
|
Endorsements |
includes med mal
|
Other Policy Details
Other Policy Name 1 |
Crime
|
Effective Date 1 |
11/01/2021
|
Expiration Date 1 |
11/01/2022
|
Policy Amount 1 |
$2,000,000.00
|
Endorsements 1 |
LP
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