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PROCARE WORK INJURY CENTER
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Last modified
4/16/2020 3:12:02 PM
Creation date
4/16/2020 3:08:48 PM
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Contracts
Company Name
PROCARE WORK INJURY CENTER
Contract #
N-2020-083
Agency
Human Resources
Expiration Date
6/30/2021
Insurance Exp Date
3/18/2021
Destruction Year
2026
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OTHER RELATED PHYSICIAN <br />CERTIFICATE OF PROFESSIONAL LIABILITY COVERAGE <br />THROUGH MUTUAL PROTECTION TRUST (MPT) <br />Name of Worker: Tracy Lee, MD <br />Type of Worker: Other Related Physician <br />This Certificate shall remain in force unless cancelled or amended by MPT or the Member/Covered Entity. <br />This Certificate of Professional Liability Coverage is incorporated by this reference into the MPT <br />Agreement. <br />MPT does not track Claims asserted against employees or Other Related Physicians. <br />The above -named Member/Covered Entity is responsible for notifying MPT and all recipients of <br />this Certificate of Professional Liability Coverage in the event of the termination of the <br />employment of or other relationship with the above -named Worker. Such Member/Covered Entity <br />is also responsible for notifying all recipients of this Certificate of Professional Liability Coverage <br />in the event that any term of this Certificate of Professional Liability Coverage is modified. <br />Date: December 30, 2019 MUTUAL PROTECTION TRUST <br />Alfred De Leon <br />Vice President, Membership Services <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DivisioN <br />A9 2020 <br />�ANGiE ACEVEdO <br />
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