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SH17-040 2018 INMATE MEDICAL - 2018 Insurance Policies
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11. November
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2018-11-20 10:00 AM - Commissioners' Agenda
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SH17-040 2018 INMATE MEDICAL - 2018 Insurance Policies
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Last modified
11/15/2018 12:54:46 PM
Creation date
11/15/2018 12:54:40 PM
Metadata
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Meeting
Date
11/20/2018
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
e
Item
Request to Approve an Amendment to the Professional Services Agreement between Kittitas County and Family Healthcare of Ellensburg for 11/1/18-12/31/18
Order
5
Placement
Consent Agenda
Row ID
49352
Type
Contract
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Physicians s.Insurance <br />A MUTUAL COMPANY <br />CONFIRMATION OF INSURANCE COVERAGE <br />PROFESSIONAL LIABILITY INSURANCE POLICY <br />CLAIMS-MADE <br />Named Insured:Elkhorn Valley Corp dba Family Health Care Policy Number:002258000 <br />of EIIensbura <br />Paramedical Employee:Aaron David Long,ARNP Reference Number:376778 <br />Mailing Address:107 E Mountain Vw Ave Ste 1 <br />Ellensburg,WA 98926 <br />POLICY PERIOD:January 1,2018 to January 1,2019 <br />at 12:01 a.m.local time at the address shown above <br />RETROACTIVE DATE:September 1,2012 <br />This document will confirm that Physicians insurance A Mutual Company (the <br />Company)provides professional liability insurance to Aaron David Long,ARNP, <br />subject to the Company's minimum liability limits of $1,000,000 each medical <br />incident and $5,000,000 aggregate. <br />The certificate of insurance is issued as a matter of information only and confers <br />no rights upon the certificate holder.This confirmation does not amend,extend or <br />otherwise alter the terms,conditions or limits of the insurance afforded by the <br />policy.If the Policy,or coveragefor any person,is canceled for any reason or if <br />the terms of the policy are changed,we will notify the Named Insured only. <br />This confirmation was issued on November16,2017. <br />To our Insureds:This confirmation of coverage is provided for your use for hospital privilege requirements, <br />HMOs,PPOs,etc.You are authorized to photocopy and distribute as needed without further permission <br />from or notification to the Company. <br />376778 72 376778 002258 <br />COI-Pl.080712
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