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2024-182-E-KKJ Forensic and Psychological Services-psychological services
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2024-182-E-KKJ Forensic and Psychological Services-psychological services
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Last modified
5/28/2024 8:28:39 AM
Creation date
5/28/2024 8:28:34 AM
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Template:
Contract
Date
3/18/2024
Contract Starting Date
3/18/2024
Contract Ending Date
3/26/2024
Contract Document Type
Contract
Amount
$18,000.00
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Tican Properties 2828 Picket Rd Ste. 210 Durham NC 27705 <br />Additional Named Insured <br />Name Address City State Zip <br />KKJ Forensic and Psychological Services, PLLC 5317 Highgate Dr Ste 213 Durham NC 27713 <br />The Purpose Center 5317 Highgate Dr Ste 213 Durham NC 27713 <br />RATING DETAIL <br />Base Premium:$2,580.00 <br />35% Part-Time Credit $-591.00 <br />4%Staff-Size Credit $-60.00 <br />10% Vicarious Liability Surcharge $-348.00 <br />Licensing Board Defense/Other Governmental Regulatory Body Defense $75.00 <br />TOTAL PREMIUM $1,656.00 <br />812 Rate Summary Page | 2 <br />Rate Summary (continued) <br />78G27815467 <br />DocuSign Envelope ID: ACEF8EF9-2EFA-4F7D-B215-CAC4F234E1F6
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