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WITTMAN ENTERPRISES, LLC HIPAA BUSINESS ASSOCIATE AGREEMENT -2009
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WITTMAN ENTERPRISES, LLC HIPAA BUSINESS ASSOCIATE AGREEMENT -2009
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Last modified
6/25/2014 10:41:22 AM
Creation date
8/7/2009 4:44:08 PM
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Contracts
Company Name
WITTMAN ENTERPRISES, LLC/HIPAA BUSINESS ASSOCIATE AGREEMENT
Contract #
A-2009-059
Agency
FIRE
Council Approval Date
6/1/2009
Expiration Date
6/30/2012
Insurance Exp Date
7/1/2013
Destruction Year
2017
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canto. CERTIFICATE OF LIABILITY INSURANCE OPID <br />DATE(MMJDD /YYYY) <br />PRODUCER WITTM -1 06/23/08 <br />THIS CERTIFICATE IS �u AO A MATTER <br />Intercare Insurance Solutions ONLY AND CONFERS NO RIGHTS UPON T EOCERTIFFICATEION <br />3010 Lava Ridge Ct. , Ste 110 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Roseville CA 95661 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br />Phone :916- 677 -2100 Fax:916- 677 -2473 <br />-INSURED - - - -- -- - -- INSURERS AFFORDING COVERAGE NAIC # <br />INSURER A: Republic Indemnity Ins CO <br />INSURER B: <br />POtBoxn26911prises LLC INSURER <br />Sacramento CA 95826 INSURER <br />COVERAGES NSURER E: -- - - -_ -- <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />7GEN7ERAIL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br />LIABILITY DATE MM /DD/YY DATE MM /DD /YY LIMITS <br />MERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS MADE�� QCCUR PREMISES (Ea occurence) I $ <br />MED EXP (An on <br />y e person) $ <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />POLICY PRO- <br />JECT LOC <br />AUTOMOBILE LIABILITY <br />r ANY AUTO <br />� ALL OWNED AUTOS <br />I SCHEDULED AUTOS <br />HIRED AUTOS <br />—I NON -OWNED AUTOS <br />1 <br />GARAGE LIABILITY <br />ANY AUTO <br />I— —I <br />EXCESS /UMBRELLA LIABILITY <br />OCCUR I <br />,. - CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION $ j <br />WORKERS COMPENSATION AND <br />A EMPLOYERS' LIABILITY <br />ANY ICEWMEMBER'PARTNER, DxECUrIVE 16620404 <br />If yes, describe under <br />I SPECIAL PROVISIONS below <br />IDESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXC <br />CERTIFICATE HOLDER <br />The Ciity of Santa Ana <br />1439 Broadway <br />Santa Ana CA 92701 <br />-- �4uu Iluts) <br />�1 TO FO <br />City Attorney <br />NS ADDED BY ENDOR <br />PERSONAL & ADV INJURY $ <br />GENERALAGGREGATE $ <br />PRODUCTS - COMP /OP AGG $ <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY <br />(Per person) <br />$ <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />AUTO ONLY - EA ACCIDENT $ <br />- -- <br />OTHER THAN EA ACC <br />I ._. _ <br />$ <br />- - <br />AUTO ONLY <br />AGG <br />- -- - -- <br />$ <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />- <br />�— <br />i$ <br />I --I I U17 LIMI I S )—. 1 ER L— <br />07/01/08 07/01/09 E.L EACHACCIDENT- - - <br />s 100000.0_ <br />EL DISEASE EA FNIPL r- $ 1000000 <br />I OYE_� - - -- <br />1--� ---------------- .�---- - - -- -0 <br />El DISEASE POLICY LIMIT i$ .100000 <br />MENT / SPECIAL PROVISIONS <br />SANTANA <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 O DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER N MED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR ABILITY F ANY�ND L, E INSURER, ITS AGENTS OR <br />REPRESENTATIVES. n <br />Kristen <br />ACgRP CORPORATION 1988 <br />
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