Enter Basic Contract Information
Administrative Information
Basic Contract Details
| Vendor Name |
The Maple Counseling Center
|
| Vendor Number (3____ for AP and 00___ for AR) |
314290
|
| Vendor Contact Name |
Varina Bleil
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Counseling Services
|
| Contract / Amendment Amount |
$35,221.00
|
| 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? |
009045
|
| Supplemental Insurance (for Risk team only) |
---
|
Upload Contract Documents
Upload Documents
Supplemental Risk Information
General Liability Details
| Policy Effective Date |
9/30/20
|
| Policy Expiration Date |
09/30/21
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
PNC, AI, WOS
|
Automobile Policy Details
| Effective Date |
09/30/20
|
| Expiration Date |
09/30/21
|
| Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
| Effective Date |
03/14/21
|
| Expiration Date |
03/14/22
|
| Policy Amount |
$1.00
|
| Endorsements |
WOS
|
Professional Liability Policy Details
| Effective Date |
09/30/20
|
| Expiration Date |
09/30/21
|
| Policy Amount |
$3,000,000.00
|
Other Policy Details
| Other Policy Name 1 |
Sexual Abuse / Molestation
|
| Effective Date 1 |
09/30/20
|
| Expiration Date 1 |
09/30/21
|
| Policy Amount 1 |
$1,000,000.00
|
| Other Policy Name 2 |
Cyber Liability
|
| Effective Date 2 |
09/19/20
|
| Expiration Date 2 |
09/19/21
|
| Policy Amount 2 |
$1,000,000.00
|
