My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
WITTMAN ENTERPRISES, LLC/HIPAA BUSINESS ASSOCIATE AGREEMENT 6A-2012
Clerk
>
Contracts / Agreements
>
W
>
WITTMAN ENTERPRISES, LLC/HIPAA BUSINESS ASSOCIATE AGREEMENT 6A-2012
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/20/2013 2:53:47 PM
Creation date
1/8/2013 5:01:40 PM
Metadata
Fields
Template:
Contracts
Company Name
WITTMAN ENTERPRISES, LLC/HIPAA BUSINESS ASSOCIATE AGREEMENT
Contract #
A-2009-059-01
Agency
FINANCE & MANAGEMENT SERVICES
Expiration Date
6/30/2014
Insurance Exp Date
7/1/2014
Destruction Year
2019
Notes
a-2009-059
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
8
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
WITTENT-01 AGIMROTH <br />'4` °,R° CERTIFICATE OF LIABILITY INSURANCE <br />1 <br />DA <br />O <br />IDYYYY) <br /> 6 <br />13 <br />114/20 <br />8114/ <br />013 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy0es) must be endorsed. It SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in Ilw of such endorsement(s). <br />PRODUCER CONTACT <br />NAME: <br />Western Elite Insurance Solutions P e 259-6900 <br />(916) <br />(966) 2-0---- <br />6.8646 <br /> <br />Destiny Drive <br />6970 __, e; <br />__..___ <br />M9.E91: <br />Rocklin, CA 95677 _ <br />ADDRESS: <br /> W5URER(S7 AFFOROURCOVERAGE NAILS <br /> _____ <br />NWRER A: Granite State Insurance 23809 <br />Msuaeo <br />INSURER B: <br />Wittman Enterprises LLC INSURERC: <br />PO Boa 269110 INSURER D : <br />-"- -_-- <br />Sacramento, CA 95828 <br />?1 <br />/y <br />/J? INSURER E_... _.._.__._._._...____. <br />/ <br />{- V <br />r `osei-DI <br />- <br /> INSURER F: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> <br />iF__-060EY7Y ............ <br />TRSR <br />0 WEIR <br /> TYPE OF INSURANCE 1. POLICY NUMBER NAMMONYYY1 TTY LIMIT S <br /> GENERAL UABUTY EK OCCIIPRENce S <br /> COMMERCMI GENERALLM9altt `PREM? EOaE? S <br /> <br />CLAIMS-MADE L? OCCUR <br />! <br />MED BAR (A, arse Penw,) _ <br />S <br /> PERSONAL A AOY INJURY 3 <br /> I GENERAL AGGREGATE S <br /> _ <br />GWL AGGREGATE LIMITAPPLIESPER. PRODUCTS -COMPpP AGO S <br />- <br /> PDUCY PRO. LOC s <br />-- <br /> AUT OMOSILELIABILITY 4[O?NBM LIMI <br />-LFiA1 epideM <br /> ANY AUTO . BODILY INJURY (PM" 3.) S <br /> ALL O?FO SCHEDULED <br /> D N S <br /> HMEDAUTOS <br />R <br />AUTOS <br />od.t) <br />API, <br /> $ <br /> UMBRELLA LAS OCCUR EACH OCCURRENCE I S <br /> EXCESS LW ctaMS+AAce I AGGREGATE ! S <br /> __. <br /> DED RETENTIONS I S <br /> VIO RKERSCOMPENSATION <br />XT <br />V STATU- JOTH-1 <br /> A <br />AND E <br />MPLOYERS'UASIUTY YIN T <br />-1-1 . <br />A ANY PROPNETOPJPARTNEREXECUTIVE <br />OFFICERMIEMIER EXCLUDED? <br />NIA lIC161250372 71112013 I 7112014 E I.. EACH ACCIDENT 11000.00 <br />S <br /> (Mmdalmyln NH) _ <br />EL DISEASE - EA EMPLO _ <br />3 1,000,000 <br /> N Yu.dMMwe wldM -- ------- <br /> OESCRIPTICNOFOPERATIONSb. E.L. DISEASE - POLICY LINT S 11000,00 <br /> i <br />DESCRIPMN OF WUAnONSI LOOATIONSI VEHICLES (AII4Ch ACORD Im, Ad4iti.V W..K, SChedVle, N RM4.pm.l. r. <br /> <br />SIC <br />O <br />FO v7 <br />r Sa <br />,D?9SS' <br />ndo <br />S <br />Cr <br />y <br />'9t <br />The City of Santa Ana <br />1439 S. Braodway <br />Santa Ana, CA 92707 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />®1988-2010 ACORD CORP <br />AVUHU 25 (2010105) The ACORD name and logo are registered marks of ACORD
The URL can be used to link to this page
Your browser does not support the video tag.