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PSA Public Safety Psychological Services
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2024
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02. February
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2024-02-20 10:00 AM - Commissioners' Agenda
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PSA Public Safety Psychological Services
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Last modified
2/22/2024 9:42:01 AM
Creation date
2/22/2024 9:41:45 AM
Metadata
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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
Fully Executed Version
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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trH IJ EI EI' <br />ACE American lnsurance <br />Company <br />PRODUCER NUMBER 273865 <br />Notice of claim should be sent to: <br />Trust Risk Management Services, lnc. <br />111 Rockville Pike Ste 700 <br />Rockville MD 20850 <br />Psychologists' Professional Liability <br />Occurrence lnsurance <br />Policy Declarations <br />DATE OF ISSUE 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 />5 All other correspondence should be sent to: <br />Trust Risk Management Services, lnc. <br />1791 Paysphere Circle <br />Chicago, lL 60674 <br />Item POLICYiCERTIFICATE NUMBER: 88c287403G0 <br />1 <br />Named Insured: <br />Address: <br />City, State & Zip Code: <br />LEPS-PSS, PLLC <br />20818 44Th Ave W Ste 150 <br />Lynnwood, WA 98036 7734 <br />2 Policy Period <br />12:01 A.M. local time at the address shown in ltem 1 <br />From: 1112012023 To: 1112012024 <br />COVERAGE LIMITS OF LIABILITY <br />$1,000,000 Eachlncident $3,000,000 Aggregate <br />$5,000 Aggregate <br />REIMBURSEMENTS <br />Professional Liability <br />Wrongful Employment <br />Practices <br />Licensing Board Defense <br />Other Governmental Regulatory <br />Body Defense <br />Deposition Expense <br />Premises Medical Payment <br />Assault and/or Battery <br />Loss of Earnings $500 per Dav. per lnsured <br />$5,000 <br />$5,000 <br />per Proceeding <br />per Proceeding <br />$5,000 <br />$2,500 <br />per Insured <br />per Person Aggregate <br />Aggregate <br />Aqqreoate Per lncident <br />$75,000 <br />$1,000 <br />$15,000 <br />Surcharge(s) <br />PREMIUM <br />$1,968.00 <br />3 <br />Total Premium $1,968.00 <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, PF33748 ,PF15216a (05/07), CC-1K1 1k(04122),PF15234a,PF23382, PF15235a, PF15313b, pF28030, pFt7s14 <br />(02t05), <br />PF-15214a (04107)O 2007 The Trust
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