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2018-296-E Health - Melynee Falk audiology services
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2018-296-E Health - Melynee Falk audiology services
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Last modified
9/7/2018 2:40:12 PM
Creation date
9/7/2018 2:37:56 PM
Metadata
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Template:
Contract
Date
7/1/2018
Contract Starting Date
6/1/2018
Contract Ending Date
5/31/2019
Contract Document Type
Agreement - Services
Amount
$77,597.00
Document Relationships
R 2018-296 Health - Melynee Falk audiology services
(Attachment)
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2018
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MEMORANDUM OF INSURANCE Date Issued <br />Prod ucer <br />coverages afforded by the Certificate listed below. <br />Company Afford ing Coverage <br />Insured <br />This is to certify that the Certificate listed below has been issued to the insured named above for the policy period indicated, not <br />withstanding any requirement, term or condition of any contract or other document with respect to which this memorandum may be <br />issued or may pertain, the insurance afforded by the Certificate described herein is subject to all the terms, exclusions and conditions of <br />such Certificate. The limits shown may have been reduced by paid claims. <br />The Memorandum of Insurance and verification of payment are your evidence of coverage. No coverage is afforded unless the premium <br />is successfully paid in full. <br />Type of Insuran ce Certificat e Number Effective Date Expirati on Date Limits <br />Pro fessional Liability Per Incident/ <br />Occurrence <br />Annual Aggregate <br />PROOF OF INSURANCE <br />Memorandum Holder:Should the above describe <br />of any kind up <br />representatives. <br />Authorized Representative <br />Joan O’Sullivan <br />Client # 2271544 <br />01/26/2018 <br />Melynee M Falk <br />1406 Valleymede Road <br />Greensboro NC 27410 <br />SpeechLangH SE <br />Speech Language Pathologist <br />AHY-860875002 04/01/2018 04/01/2019 $1,000,000 <br />$3,000,000 <br />Mercer Consumer, a service of Mercer Health & Benefits Administration LLC. In CA d/b/a Mercer Health & Benefits Insurance Services LLC. CA Ins Lic. #0G39709 <br />PROOF OF COVERAGE ONLY <br />Mercer Consumer, a service of <br />Mercer Health & Benefits Administration LLC <br />P.O. Box 14576 <br />Des Moines, IA 50306-3576 <br />1-800-503-9230 <br />Liberty Insurance Underwriters Inc <br />Mark Brostowitz <br />DocuSign Envelope ID: BB4B5E63-95D6-479B-914C-72E3500C9FAC
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