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2016-352-E Health - Family Centered Healthcare, PA - primary care for uninsured males of OC
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2016-352-E Health - Family Centered Healthcare, PA - primary care for uninsured males of OC
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Last modified
8/9/2016 11:09:02 AM
Creation date
7/14/2016 1:48:43 PM
Metadata
Fields
Template:
BOCC
Date
7/13/2016
Meeting Type
Work Session
Document Type
Agreement
Agenda Item
Manager signed
Amount
$30,000.00
Document Relationships
R 2016-352-E Health - Family Centered Healthcare, PA - primary care for uninsured males of Orange County
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2016
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DocuSign Envelope ID:977F9724-0D69-4F35-BE42-796A38945969 <br /> WC 99 06 02 <br /> EXTENSION OF INFORMATION PAGE <br /> Worker's Compensation and <br /> Employer's Liability Policy <br /> LOCATION SCHEDULE <br /> Policy Number: MWC0071930-02 <br /> Issued to: Family Centered Healthcare INC <br /> Effective Date: 11/17/2015 to 11/17/2016 <br /> Coverage Provided By: Markel Insurance Company <br /> Carrier Code 22616 <br /> Other workplaces not shown above: <br /> SIC <br /> Location FEIN PHONE CODE ENTITY TYPE <br /> 1 400 Millstone Dr Ste 100 800240291 919-619-3018 8011 Corporation <br /> Hillsborough, NC 27278-9007 <br /> ©1991 National Council on Compensation Insurance. 5 of 6 <br />
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