Enter Basic Contract Information
Administrative Information
Basic Contract Details
| Vendor Name |
Saban Community Clinic
|
| Vendor Number (3____ for AP and 00___ for AR) |
300234
|
| Vendor Contact Name |
Adam Friedman
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
2020-21 Contract Renewal
|
| Contract / Amendment Amount |
$199,636.00
|
| Is this a new agreement or an amendment to an existing agreement? |
Amendment
|
| If this is if a Contract Amendment, what is the Contract Number? |
9602
|
| Supplemental Insurance (for Risk team only) |
---
|
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Supplemental Risk Information
General Liability Details
| Policy Effective Date |
07/01/20
|
| Policy Expiration Date |
07/01/21
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
PNC, AI, WOS
|
Automobile Policy Details
| Effective Date |
07/01/20
|
| Expiration Date |
07/01/21
|
| Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
| Effective Date |
07/01/20
|
| Expiration Date |
07/01/21
|
| Policy Amount |
$2,000,000.00
|
| Endorsements |
WOS
|
Other Policy Details
| Other Policy Name 1 |
Sexual Misconduct
|
| Effective Date 1 |
07/01/20
|
| Expiration Date 1 |
07/01/21
|
| Policy Amount 1 |
$1,000,000.00
|
| Other Policy Name 2 |
Crime Coverage
|
| Effective Date 2 |
07/01/20
|
| Expiration Date 2 |
07/01/21
|
| Policy Amount 2 |
$1,000,000.00
|
