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SH21-044 - ELLENSBURG FAMILY MEDICINE PSA 2 SIDED - FULLY EXECUTED
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06. June
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2022-06-21 10:00 AM - Commissioners' Agenda
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SH21-044 - ELLENSBURG FAMILY MEDICINE PSA 2 SIDED - FULLY EXECUTED
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Last modified
6/16/2022 1:20:05 PM
Creation date
6/16/2022 1:18:33 PM
Metadata
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Template:
Meeting
Date
6/21/2022
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
g
Item
Request to Approve the Professional Services Agreement between Kittitas County and Ellensburg Family Medicine (Modification of the Existing Agreement)
Order
7
Placement
Consent Agenda
Row ID
90804
Type
Agreement
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The Medical Protective Company® <br />A STOCK INSURANCE COMPANY <br />5814 Reed Road,Fort Wayne,Indiana 46835 <br />Strength.Defense.Solutions.Since 1899. <br />MULTI-SPECIALTY HEALTIICARE PROFESSIONAL <br />MASTER POLICY <br />CERTIFICATE OF INSURANCE <br />SClfEDULE OF POLICY FORMS &ENDORSEMENTS <br />Forms and Endorsements of your Certificate are as follows: <br />Form #Description <br />|Form No.iTitle <br />----+-------------------------------------------------------------------------- <br />|MCL ICover Letter <br />)18011 IMPS Multi-Specialcy Bealtheare Professionals Policy Certificate | <br />|1B507 MPS Multi-Specialcy Mealtheare Professionals Form &Endorsement Schedule <br />|18505 |MFS Multi-specialEy Healthcare Professionals Policy Schedule of Insurede i <br />118511 IGeneral Definitions <br />|18519 IGeneral Conditions <br />[19522 1General Exclusions <br />|18528 |Professional Liability Insuring Agreement -Occurrence <br />|18560 ICammercial General Liability Insuring Agreement -Occurrence <br />118617 10isclosure Notice of Terrorism Insurance Coverage ! <br />118620 ICap on Losses from Certified Acts of Terrorism Endorsement <br />119565 [Additional Insured -Lessors of Premises &Leased Equipment <br />|19120 IMPS Economic Sanctions Exclusion Endorsement <br />[19121 1Economic Sanctions Exclusions Endorsemenc (GL)| <br />|19098 IMPS Blanker Separate Limit Endorsement -PL Only i <br />|19187 IBiomedical Waste Hearing Expense Endorsement -Occurrence | <br />|19218 IReuse or Multidase Supply Procedure Exclusion Endorsement | <br />|19631 |Procedures Exclusion Endorsement | <br />18752 |Washington Amendatory Endorsement <br />÷--------------+---------------------------------------------------- <br />-------------------------------÷ <br />18507 All other terms and conditions of the Policy remain unchanged.08/13
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