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SH24-004 PSA
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2024-02-20 10:00 AM - Commissioners' Agenda
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SH24-004 PSA
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Entry Properties
Last modified
2/15/2024 12:10:42 PM
Creation date
2/15/2024 12:07:47 PM
Metadata
Fields
Template:
Meeting
Date
2/20/2024
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Item
Request to Approve a Professional Services Agreement between Kittitas County and Public Safety Psychological Services
Order
9
Placement
Consent Agenda
Row ID
114588
Type
Agreement
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ACE American Insurance <br />Company <br />PRODUCER NUMBER 273865 <br />Psychologists' Professional Liability <br />Occurrence Insurance <br />Policy Declarations <br />DATE OF ISSUE I December 21, 2023 <br />PSYCHOLOGISTS' PROFESSIONAL LIABILITY <br />OCCURRENCE INSURANCE POLICY <br />THIS POLICY/CERTIFICATE IS ISSUED IN ASSOCIATION WITH THE PSYCHOLOGISTS PURCHASING <br />GROUP ASSOCIATION <br />Item <br />POLICY/CERTIFICATE NUMBER: 88G28740360 <br />Named Insured: <br />LEPS-PSS, PLLC <br />1. <br />Address: <br />20818 44Th Ave W Ste 150 <br />City, State & Zip Code: <br />Lynnwood, WA 98036 7734 <br />2. <br />Policy Period: From: 11/20/2023 To: 11/20/2024 <br />12:01 A.M. local time at the address shown in Item 1. <br />3. <br />COVERAGE <br />LIMITS OF LIABILITY <br />PREMIUM <br />Professional Liability <br />$1,000,000 Each Incident <br />$3,000,000 Aggregate <br />Wrongful Employment <br />$5,000 Aggregate <br />$1,968.00 <br />Practices <br />REIMBURSEMENTS <br />Licensing Board Defense <br />$5,000 per Proceeding <br />Other Governmental Regulatory <br />$5,000 per Proceeding <br />Body Defense <br />Deposition Expense <br />$5,000 per Insured <br />Premises Medical Payment <br />$2,500 per Person <br />$75,000 Aggregate <br />Assault and/or Battery <br />$1,000 Aggregate <br />Loss of Earnings <br />$500 per Day, per Insured <br />$15,000 Aggregate Per Incident <br />Surcharge(s) <br />Total Premium <br />$1,968.00 <br />4. <br />This policy is made and accepted subject to the printed conditions in this policy together with the provisions, stipulations and <br />agreements contained in the following form(s) or endorsement(s). <br />PF15214a, P1733748 , PF15216a (05/07), CC-1K11k (04/22), PF15234a, PF23382, PF15235a, PF15313b, PF28030, PF17914 <br />(02/05), <br />5 <br />Notice of claim should be sent to: <br />All other correspondence should be sent to: <br />Trust Risk Management Services, Inc. <br />Trust Risk Management Services, Inc. <br />111 Rockville Pike Ste 700 <br />1791 Paysphere Circle <br />Rockville MD 20850 <br />Chicago, IL 60674 <br />PF-15214a (04/07) © 2007 The Trust <br />
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