REQUEST FOR PROPOSAL Insurance Benefits Consultant. DUE DATE: June 18, :00 a.m.

Transcription

1 REQUEST FOR PROPOSAL Insurance Benefits Consultant DUE DATE: June 18, :00 a.m. CITY OF LA MARQUE 1111 Bayou Road La Marque, Tx (409)

2 COVER SHEET INDEX SECTION I SECTION II SECTION III SECTION IV SECTION V SECTION VI SECTION VII NOTICE TO OFFERORS GENERAL TERMS & CONDITIONS QUALIFICATIONS / COMPANY OVERVIEW / OPERATIONAL INFORMATION PROPOSAL CONTENT & EVALUATION CRITERIA SPECIFICATIONS RFP FORM/PRICING EXHIBITS: 1. BID ENDORSEMENT 2. INSURANCE REQUREMENTS 3. BIDDERS QUALIFICATION STATEMENT 4. NO BID RESPONSE 5. SUPPLEMENTAL INFORMATION 6. BID BOND CONFLICT OF INTEREST

3 SECTION I NOTICE TO OFFERORS Introduction: The City of La Marque is seeking qualified bidders to assist with consulting and administering the city s benefits and insurance, including medical, dental, vision, life, accidental death, long term disability, etc. It is the goal of the City to provide competitive and affordable (according to market standards) benefit plans which are accessible to all eligible employees and/or retirees. Currently there are approximately 110 benefit eligible employees and 6 retirees enrolled in the plan. Plan year begins October 1st and ends September 30 th. Enrollment needs to begin no later than August 31 st. Preparation and Submittal Instructions Official submittal of the proposal shall consist of one original proposal clearly marked Original, two (2) paper copies of the proposal enclosed in a sealed envelope, and one electronic version on a flash drive or equivalent sent to the City of La Marque. The following label must be displayed on the outside of a sealed envelope at delivery time: Sealed Bid Proposal Proposal # Description INSURANCE BENEFITS CONSULTANT Due Date Due Time Company Name

4 Sealed offers are to be submitted to: City of La Marque Attn: City Clerk 1111 Bayou Road La Marque, TX NO LATE OFFERS WILL BE ACCEPTED OR FACSIMILE PROPOSALS WILL NOT BE ACCEPTED The City is requesting one (1) electronic version of the proposal be submitted on CD or thumb-drive and be included in the packet. This version alone does not meet the conditions of an official proposal. The required format for the electronic version is Microsoft Word. Proposals are to be in either sealed envelope or sealed box with proper label. Proposals must be received and time stamped by City Clerk or designee no later than the date and time listed. Individual Proposals will not be read in public, only the company names of those responses received will be read. No proposals should be submitted in plastic sleeves or spiral binders. Responses shall be submitted in 3 ring binders, clearly identified/tabbed. The submitted proposal must be received by City Clerk or designee prior to the time and date specified. The mere fact that the proposal was dispatched will not be considered. The respondent must insure that the proposal is actually delivered. Late proposals will not be considered. Until award of contract is made, per section (b) of the Texas Local Government Code, there will be no disclosure of contents to competing offerors. All proposals will be kept confidential during the negotiation process. Except for the trade secrets and confidential information, which the respondent identifies as proprietary, all proposals will be open for public inspection after the contract is awarded.

5 Respondents may withdraw their proposal at any time prior to the time specified as the closing time for acceptance of proposals. However, no respondent shall withdraw or cancel their proposal for a period of ninety (90) days after closing date for acceptance of proposals. All cost directly or indirectly related to preparation of a response to the RFP or any oral presentation required to supplement and/or clarify a proposal which may be required by the City shall be the sole responsibility of and shall be borne by the respondent. During proposal development, respondent s questions regarding the RFP or the process should be directed to Suzy Kou, Finance Director, 1111 Bayou Road, La Marque, Texas or via at financedirector@cityoflamarque.org. The City of La Marque advises that respondents to the Request for Proposal not contact the City Staff and/or any member of the City Council or the Mayor during the proposal process and evaluation phase. Proposal Information All questions regarding proposal preparation, the selection process, specifications and interpretations of the terms and conditions of the bid shall be submitted in writing. Any addenda will be issued no later than three (3) calendar days prior to the deadline for submission of offers. Costs for developing/producing proposal response and possible subsequent interview or presentation are entirely the obligation of the proposer and shall not be chargeable in any manner to the City of La Marque. All proposals will be reviewed and evaluated by City staff. The City reserves the right to evaluate each proposal on a separate and individual basis, to invite selected firms to make personal presentations to staff. The City further reserves the right to reject any and all proposals submitted, or accept a proposal deemed most advantageous to the City. Confidential or Proprietary Information If a proposer believes that parts of an offer are confidential, then the proposer must so specify. The proposer must stamp in bold letters the term CONFIDENTIAL on that part of the offer which the

6 proposer believes to be confidential. The proposer must submit in writing specific detailed reasons, including any relevant legal authority, stating why the proposer believes the material to be confidential. Vague and general claims as to confidentiality will not be accepted. The City of La Marque will be the sole judge as to whether a claim is general and/or vague in nature. All offers and parts of offers, which are not marked as confidential, will be automatically considered public information after the contract is awarded. The successful offer may be considered public information even though parts are marked confidential. ADDENDUMS/AMENDMENTS Any interpretations, corrections and/or changes to a bid solicitation or extensions to the opening date will be made by addenda to the respective document when necessary. An addendum will be published and distributed by to all that are known to have received a copy of the bid and related specifications. However, it shall be the sole responsibility of the Proposer to verify issuance/non-issuance of addenda and to check all avenues of document availability prior to opening date and time to insure Proposer s receipt of any addenda issued. No addenda will be issued 3 days prior to bid opening. The last day for questions will be on May 29, 2015 at 5:00 PM. The last day for addenda will be on June 12, 2015 at 5:00 PM. The offeror is required to acknowledge receipt of any amendments by submitting a signed copy of each amendment issued. Signed copies must be submitted as part of the signed proposal submittal. Consideration of Proposal The City reserves the right to accept or reject any or all proposals, to waive any and all informalities and technicalities, and to accept the offer considered to be in the best interest of the City of La Marque. The City also reserves the right to reject the proposal of any respondent who previously failed to perform properly or complete on time, agreements of similar nature, or to reject the proposal from any respondent who is not in a position to perform specified requirements contained therein.

7 Award The City of La Marque intends to make an award using the evaluation criteria and other factors as indicated in this solicitation. Contract Administration The City of La Marque Human Resources together with the Finance Department shall be responsible for administration of this purchase for compliance with the interpretation of scope, schedule, billings, requirements, and budget. Substantive Proposals The respondent shall certify (a) that his/her bid submittal is genuine and is not made in the interest of, or on behalf of, any undisclosed person, firm, or corporation; (b) that he has not directly or indirectly induced or solicited any other respondent to put in a false or sham bid; (c) that he has not solicited or induced any other person, firm, or corporation from proposing; and (d) that he has not sought by collusion to obtain for himself any advantage over other respondents or over the City of La Marque. The City of La Marque may make such investigations as it deems necessary to determine the ability of the Proposer to provide satisfactory performance in accordance with bid requirements, and the respondent shall furnish to the City all such information and data for this purpose. Definitions Proposer refers to submitter. Vendor refers to Successful Proposer or Contractor Submittal refers to those documents required to be submitted to the City of La Marque, by a Proposer. Inquiries Questions about this RFP shall be in writing and directed to Suzy Kou at the following address. Questions resulting in changes to this solicitation will be provided in the form of an amendment to the solicitation.

8 Suzy Kou Finance Director 1111 Bayou Road La Marque, Texas Schedule of Events The upcoming schedule of events is tentatively scheduled as follows: Advertise Requirement May 8, 2015 Advertise Requirement May 15, 2015 Issue Request for Proposal May 8 and 15, 2015 Questions Due Addendum Proposal Submittal Due Date May 29, 2015 at 5:00 PM June 12, 2015 at 5:00 PM June 18, 2015 at 10:00 AM

9 SECTION II TERMS AND CONDITIONS 1. The City of La Marque will accept SEALED PROPOSALS Monday through Friday, 8:00 a.m. 5:00 p.m. Proposals must be received by City Clerk or designee before the specified hour and date of the opening. At that time proposals shall be opened and names publicly read. 2. All sealed offers should be submitted on the original forms provided. Each proposal must be sealed and should be placed in a properly identified envelope with proper label showing RFP number, time and date of RFP opening. 3. Late proposals will be UNOPENED. Late proposals will not be considered under any circumstances. 4. Proposals CANNOT be altered or amended after opening time. Any alterations made before opening time must be initialed by offeror or his authorized agent. No proposal may be withdrawn after opening without approval, and based on a written acceptable reason. 5. The City of La Marque reserves the right to revise or amend the specifications prior to date set for opening proposals. Such revisions or amendments, if any, will be announced by amendments or addendum to these specifications. Copies of such amendments or addendum so issued will be furnished to all prospective offerors. If offeror demonstrates just reason for a change, the City of La Marque must have at least three working days notice prior to bid opening date. 6. Should offeror find discrepancies in or omissions from the specifications or other documents or be in doubt as to their meaning, offeror should at once notify the Finance Department and obtain clarification prior to submitting a proposal. 7. Price should include all costs including shipping, handling, and other related costs. 8. Proposals shall be valid for ninety (90) days from opening date. 9. The City of La Marque is exempt from taxes. DO NOT INCLUDE TAX IN PROPOSAL. 10. The City of La Marque reserves the right to terminate this contract for any reason by notifying the Contractor/Supplier in writing thirty (30) days prior to the termination of this agreement. 11. Offeror MUST give full firm name and address. Person signing bid should show TITLE or AUTHORITY TO BIND HIS FIRM IN A CONTRACT. Authorized signature should appear on each page of the proposal in the space provided. 12. Any catalog, brand name or manufacturer s reference used in proposal invitation is descriptive NOT restrictive it is to indicate type and quality desired. Proposals on brands of like nature and quality will be considered. If proposing on other than reference specifications, offeror must show manufacturer, brand or trade name, lot number, etc., of article offered. If other than brand(s) specified is offered, illustrations and complete description should be made part of the proposal. If offeror takes no exceptions to specifications or reference data, he will be required to furnish brand names, numbers, etc., as specified. All items proposed shall be new, in first class condition and manufacturer s latest model and design including containers suitable for shipment and storage, unless otherwise indicated in RFP. Verbal agreements to the contrary will not be recognized. 13. If the brochure or information included with your proposal does not exactly describe the item to be furnished, then notes in the attached form, EXCEPTIONS TO PROPOSAL, must explain the difference. Comments in this form signify that your proposal takes exception to the stated specifications. Exceptions taken may be just cause to disqualify proposal. 14. NO substitutions or cancellations permitted without written approval of the City of La Marque. 15. All offerors must meet or exceed the minimum specifications to be considered as a valid proposal. The City of La Marque reserves the right to accept or reject all or any part of any proposal, waive minor technicalities and award the proposal to the offeror who provides goods or services at the best value for the City of La Marque. 16. DELIVERY: Specifications indicate number of days required to place material in receiving department designated location under normal conditions. A difference in delivery promise may break a tie proposal. Unrealistically short or long delivery promises may cause proposal to be disregarded. Consistent failure to meet delivery promises without valid reason may cause removal from bid list. Delivery shall be made during normal working hours only, 8:00 a.m. to 5:00 p.m. unless prior approval for late delivery has been obtained. 17. Consistent and continued tie bidding could cause rejection of bids by the City of La Marque and/or investigation for Anti-Trust violations. 18. If a proposal contains proprietary information, the offerors must declare such information as proprietary if Offeror does not want information to become public. 19. The Contractor/Supplier agrees to protect the City of La Marque from claims involving infringement of patents or copyrights.

10 20. Purchase order number should be on original invoice and invoice sent to the City of La Marque, 1111 Bayou Road, La Marque, TX 77568; Attn: Payroll. 21. The City of La Marque shall pay for the product/service within thirty (30) days of receipt and acceptance. Acceptance by the City of La Marque shall constitute all items bid being received and in good working order to the City of La Marque s satisfaction. 22. It shall be a breach of ethics to offer, give or agree to give any employee or former employee of the City of La Marque, or for any employee or former employee of City of La Marque to solicit, demand, accept or agree to accept from another person, a gratuity or an offer of employment in connection with any decision, approval, disapproval, recommendation, preparation of any part of a program requirement or purchase request, influencing the content of any specification or procurement standard, rendering of advice, investigation, auditing, or in any other advisory capacity in any proceeding or application, request for ruling, determination, claim or controversy, or other particular matter pertaining to any program requirement or a contract or subcontract, or to any solicitation or proposal therefore pending before the City of La Marque. 23. It shall be a breach of ethics for any payment, gratuity or offer of employment to be made by or on behalf of a subcontractor under a contract to the prime contractor or higher tier subcontractor for any contract for the City of La Marque, or any person associated therewith, as an inducement for the award of a subcontract or order. 24. The responder shall not accept or offer gifts or anything of value nor enter into any business arrangement with any employee, official, or agent of the City of La Marque. PRICE REVISION CLAUSE ANNUAL CONTRACTS The City of La Marque desires firm prices for the full contract period. It is recognized by the City of La Marque that qualified vendors may face unforeseen price changes from manufacturers. Unit price changes due to increases or decreases from the manufacturer will be considered pass-on costs. Pass-on increases must be verified in writing by manufacturer and will be considered during the term of the contract. NOTE: THE CITY OF LA MARQUE MUST HAVE THIRTY (30) DAYS WRITTEN NOTICE PRIOR TO ANY INCREASE OF EXISTING PRICES. INCREASES Permissible price revisions in any event shall not exceed the actual unit cost or percentage cost revisions from the manufacturer. It will ordinarily be the policy of the City of La Marque to accept manufacturer price increases, when the amount of such increases is reasonable. However, the City of La Marque reserves the right to obtain a different source or sources to such item or items which have been increased in price. DECREASES If a vendor does take advantage of this Price Revision Clause, the City of La Marque will expect any decreases in cost from the manufacturer during the term of the contract to lower the city s price for such item or items.

11 SECTION III QUALIFICATION/COMPANY OVERVIEW/OPERATIONAL INFORMATION Firm Background/Bidder Qualification/Personnel Each respondent to this proposal shall be capable of meeting the following minimum requirements: Proposers must demonstrate that they have the resources and capability to provide services per the RFP document. Proposers must demonstrate that they are financially stable and that they have been a commercial provider of said services for at least the past five (5) years. Proposer s bid price shall be sufficient to pay all applicable Federal and State withholdings, workmen s compensation insurance, and to comply with the current minimum wage. Proposers must submit with their personal proof of insurance. The awarded contractor must provide the City with their certificate of insurance, meeting all of the city s insurance requirements within five (5) working days of award notification. Failure to provide the City with a certificate of insurance, meeting all of the city s insurance requirements within five (5) working days of award notification may result in the City awarding the contract to another contractor. Company Overview Respondent shall provide the following information with their submission, including a brief company overview, history, and financial status: Address and location of the local responsible office Name of office principals, their experience, and professional qualifications. Describe your firm s experience in providing municipal financial advisory services including the number of years your firm has actively provided such services Number of employees internationally, nationally, and locally Describe your firm s annual employee attrition rate for the past three (3) years

12 Supply a list of employees who will be devoted to servicing the City s account. Individual resumes of the lead members of your service team should be supplied. Expound on the names of the employees that will be assigned to the City of La Marque account and provide the number of years they have been with your company. Provide a complete and current listing of all industry certifications, accreditations and affiliations your firm holds. Describe your firm s business continuity plan. Company Operational Information Client History Describe whether your firm (or any firm previously affiliated with your firm) has ever undergone an investigation by an outside agency pursuant to the filing of claims and describe the outcome of the investigation including ramifications to your firm or your firm s client cities. Describe whether your firm has ever lost an account due to concerns of improper billing practices, accusations or clients concerns of fraud as defined by applicable Federal or State Authorities. Describe, in detail, whether your firm has ever lost an account due to breach of contract, or incurred any unfavorable contractual outcomes (to include any terminations, etc.). References Provide five (5) recent or current (within one year) references for which you have provided the type of services described herein, specifically to municipalities in Texas. For each reference, include dates the services were performed, name, address, phone, contact person and . Questionnaire Proposals will be also evaluated against the questions set out below. CONSULTANT QUALIFICATIONS QUESTIONNAIRE The City is interested in entering into a relationship with an employee benefit consultant who is able to maximize the value of the benefit program. This will require a consultant who is experienced with cities in Texas and/or other public entities, and who is available and accessible to the staff. To assist in the evaluation of qualifications, please answer the following questions:

13 Explain what separates your company from its competitors and what specifically qualifies you to be a consultant for the City. Disclose your past and present financial relationship to any and all insurance companies, Third Party Administrators (TPA), and/or any other providers of services similar to the ones you may provide for the City of La Marque. be specific relating to the disclosure of types of income commissions, fees, and/or overrides. What types of services do you provide to self-funded health plan clients? Be specific relating to areas of expertise, and the duties you perform(ed). Describe which of the following services you have provided to your clients as well as the most significant findings of each. o Claims audits of a TPA or insurance company for a self-funded health plan. o Deployment of specialized Disease Management Programs/Wellness Programs. o Establishment and negotiation of local direct provider contracts for specific health related services. Identify the number and types of RFPs you have completed in the past 12 months for cities or public entities. Provide at least one real example of savings realized as a result of a single RFP. Identify three of your most significant accomplishments on behalf of a municipal organization or similar city in Texas. For each accomplishment, please include a client or former client s name and telephone number who can confirm each claim. What are the steps or due diligence steps you generally adopt before recommending a vendor to your client as a benefit provider?

14 SECTION IV PROPOSAL CONTENT & EVALUATION CRITERIA Proposal Response Documents/Proposal Format and Content The City of La Marque discourages lengthy and costly proposals, however, in order for the City to evaluate proposals fairly and completely, proposers should follow the format set out herein and provide the information requested. In order to be considered as responsive, the Proposer shall submit with their Proposal, such documentation as is necessary or required to attest to the company s capabilities and qualifications to perform the work as specified and all aspects of this contract in a competent manner. RFP responses shall be submitted professionally (and not bound with plastic sleeves or spiral binders) to include clearly identifiable labels, in the same order for each section provided below. Also, include the RFP Pricing Form (Excel spreadsheet), if appropriate on a flash drive. Evaluation Process and Selection Criteria The objective of this evaluation process is to identify and select the proposer that best satisfies the requirements of the City of La Marque. The City of La Marque s staff that will be responsible for these services will evaluate all proposals received by the submission deadline. The evaluation committee will review, rate and rank each proposer s proposal in accordance with the weighted ranking criteria contained in this document. RFP responses shall remain confidential until the contract has successfully been awarded. If deemed necessary to the evaluation process, the City reserves the right to conduct presentations/interviews with proposers at no cost to the city. There are 100 possible points for this proposal evaluation, as follows: Cost of Services Points are calculated using the formula below: Lowest Bid / Other Bid x Available Points (40) = Proposer s Price Score. Experience and Qualifications (Company Overview/Operational Information References Completeness and responsiveness of proposal. 40 points 25 points 25 points 10 points

15 Introduction SECTION V SPECIFICATIONS (SCOPE OF WORK AND DELIVERABLES) The City s Human Resources (HR) and Finance Department are responsible for the administration of the city s benefits and insurance, including medical, dental, vision, life, accidental death, long term disability, etc. It is the goal of the City to provide competitive and affordable (according to market standards) benefit plans which are accessible to all eligible employees and or retirees. Currently there are approximately 110 benefit eligible employees and 6 retirees enrolled in the plan. Plan year begins October 1 st and ends September 30 th. Enrollment begins no later than August 31 st. After anticipated interviews/presentations, the City expects, but is not obligated, to enter into an agreement with the selected respondent. Qualification Statement and Proposal of Work The development of an insurance benefits consultant services proposal shall include a detailed description of how the respondent proposes to achieve the desired results. Therefore, the Finance Department recommends that offerors present detailed, concise, focused, simple, and well- organized proposals. Proposals shall include a fee schedule for all services proposed. It is clearly anticipated that the consultant shall not receive a commission from any firm, provider, courier, or vendor, for selecting or recommending that the City of La Marque contract for employee benefits. If the selected broker receives commission from one or more insurance companies and/or intermediaries for the placement of insurance policies for the coverage described the fee will be reduced by the amount of such commission. Final adjustments to the fee amount will be made by the broker after the determination and receipt by the broker of all commissions, net of any adjustments pursuant to any audit, endorsement, accounting reconciliation or other applicable business process. A list of service requirements and engagement responsibilities include, but may not be limited to: Serve the City as an advisor regarding, and including the preparation of the

16 City s RFP for health plan design and content including COBRA, flexible spending account, section 125 program, HRA and/or HSA account, dental, vision, longterm disability and life insurance benefits and their components. Review, on an ongoing basis, the existing employee benefit programs for competitiveness, appropriateness and overall acceptance by plan participants. Serve and assist the City in negotiating benefits provider contract(s) resulting from the review and recommendations noted above including the use of available provider networks. Provide the City underwriting data and evaluation services to support contract modifications such as benefit differentials and funding options. Negotiate, when appropriate, long term rate(s) /service guarantees designed to meet the service delivery and financial plan of the City. Assist the City in preparing periodic reports to the City Council, City Manager, Human Resources, Finance Director, employee committee, or assigned group on the progress, applicability and overall benefit of a specific plan. Assist the City in filing all reports in accordance to federal and state requirements. Update the City with all new regulations impacting the City s plan at any time. Review utilization rates on a quarterly basis and evaluate each on the City s best option as it relates to self-funded or fully-funded plans. Assist the City with plan design changes, plan implementation strategies, plan design and/or benefits communications relating to coverage; integrating appropriate assignments of duties to vendors, while maintaining proper oversight/responsibilities. Review new or proposed administrative services provided by the City or outside vendor(s) to determine the most effective and efficient service delivery strategies. Assist the City with premium funding projections during its annual budget process. Review long term healthcare contribution philosophy and budgetary agenda and best strategies for applying identified resources to a meaningful long term benefit package. Provide the City with overall plan management and quality assurance services including, but not limited to the following: - Claims reporting - Benefit review/design - Regulatory compliance and reporting - Stop-Loss management - COBRA/HIPAA - Customer service - Open enrollment

17 - Plan administration & claims services - Renewal negotiations - Competitive bidding - Transition & implementation of plan - Analysis & selection of vendor - Underwriting services - Benefits Summary - Benefits Communications Services -On-Line Enrollment Services - Cafeteria plan admin. - Cost containment - Contract analysis - ERISA -Vendor compliance - Claims audit and review - Budgeting - Actuarial services - Wellness Programs Provide periodic comparisons of plans of benefits and employer/employee contributions to area cities and comparable businesses. Provide periodic reports using carrier data on claims and fixed expenses, and relate those to total premium and expectations for renewal. Add historical perspective to premium and claims data for all coverage and provide reports as needed by the City. Provide national, regional and local medical inflation data and compare that to specific City plan inflation. Review and make recommendations to the City on carrier cost containment mechanisms, as relates to return on investment and participant impact. Meet periodically with the City s staff relating to levels of customer service received from various carriers, and where required intercede with both parties to assist in problem resolution. Assist City employees to resolve claims issues or questions relating to benefits insurance. Consultant Insurance Please review attached exhibit Insurance Requirements. Required Information For the purpose of evaluating competency and experience, the degree of relevant experience and accomplishments with Texas cities will be a primary factor. The City is especially interested in the competency and the experience of the individuals who would be directly providing services to the City. Provide a professional resume for each of the individuals or agents you would assign to work with the City if selected as a benefits consultant. List of references from three current or former clients, including contact name, addresses, telephone number and the service provided. References must

18 be of similar size and nature to the City. Provide an outline of your hourly rates for services, as well as any proposed fee schedule you require for your services. Provide an overview of your company that included your vision, mission, and values. Include a statement on your particular approach to employee benefit consulting services; in other words, what makes your service unique. Copy of Insurance License(s) for all consultants assigned to the project. Requirements and Authority of the City This Request for Proposals does not commit the City of La Marque to award a contract, pay any costs incurred in the preparation of the proposal to this request, or to procure or contract for services. The City of La Marque reserves the right to accept or reject any or all proposals received as a result of this request, negotiate with any qualified source(s) or cancel, in part or entirely, this Request for Proposal, if it is in the best interest of the City of La Marque to do so. All submittals to the City of La Marque in response to this RFP become the property of the City of La Marque.

19 Compensation SECTION VI RFP FORM/PRICING Provide fee schedule for services related to insurance benefits consulting and for services unrelated to insurance benefits consulting and describe the basis on which the fees are calculated. Details of any alternate method of compensation your firm would consider. Identify and list all special services and identify charges, particularly disclosure requirements. The City prefers that this fee schedule, et.al, be provided in an electronic format (Excel) and a paper copy included with the submittal.

20 SECTION VII EXHIBITS EXHIBIT 1 BID ENDORSEMENT The undersigned, in submitting this proposal and their endorsement of same, represents that they are authorized to obligate their firm, that they have read this entire proposal package, is aware of the covenants contained herein and will abide by and adhere to the expressed requirements. Submittals will be considered as being responsive only if entire Bid Package plus any/all attachments is returned with all blanks filled in. SUBMITTED BY: (OFFICIAL Firm Name) Signature) Must be signed to be considered responsive (Typed or Printed Name) (Title) (Date) Remittance (Zip Code)

21 If an addendum is issued for this bid, please acknowledge receipt. ADDENDUMS/AMENDMENTS: 1) date acknowledged 2) date acknowledged 3) date acknowledged

22 Exhibit 2 CONTRACTOR INSURANCE REQUIREMENTS & AGREEMENT REQUIREMENTS Contractors performing work on City property or public right-of-way for the City of La Marque shall provide the City a certificate of insurance or a copy of their insurance policy(s) evidencing the coverages and coverage provisions identified herein. Contractors shall provide the City evidence that all subcontractors performing work on the project have the same types and amounts of coverages as required herein or that the subcontractors are included under the contractor s policy. All insurance companies and coverages must be authorized by the Texas Department of Insurance to transact business in the State of Texas and must be acceptable to the City of La Marque. Per City Purchasing policy, contractor shall not represent either expressly or through implication, that contractor is an employee, agent, official, or representative of the City. Income taxes, self-employment taxes, and the like are the sole responsibility of contractor. Listed below are the types and amounts of insurances required. The City reserves the right to amend or require additional types and amounts of coverages or provisions depending on the nature of the work. Type of Insurance Amount of Insurance Provisions 1. Workers Compensation Employers Liability Statutory Limits $100,000 per occurrence City to be provided a WAIVER OF SUBROGATION and 30 day notice of cancellation or material change in coverage. 2. Commercial General (Public) Liability to include coverage for: a) Premises/Operations b) Products/Completed Operations c) Independent Contractors d) Personal Injury e) Contractual Liability 3. Business Auto Liability to include coverage for: a) Owned/Leased vehicles b) Non-owned vehicles c) Hired vehicles Personal Injury - $1,000,000 per person; Property Damage - $1,000,000 per occurrence ; General Aggregate - $1,000,000 Combined Single Limit - $1,000,000 City to be listed as Additional Insured on Contractor s policy and provided 30 day notice of cancellation or material change in coverage.. City shall be provided 30 day notice of cancellation or material change in coverage.

23 Certificate of Insurance forms may be ed to: Questions regarding required insurance should be directed to Suzy Kou, City of La Marque Finance Director, This form must be signed and returned with your quotation. You are stating that you do have the required insurance and if selected to perform work for the City, will provide a certificate of insurance, and a copy of insurance policy with the above requirements to the City. A PURCHASE ORDER WILL NOT BE ISSUED WITHOUT EVIDENCE OF REQUIRED INSURANCE. AGREEMENT I agree to provide the above described insurance coverages within 10 working days if selected to perform work for the City of La Marque. I also agree to provide the City evidence of insurance coverage on any and all subcontractors performing work on the project. Project/Bid# Company: Vendor#(if applicable) Printed Name: Signature: Date:

24 EXHIBIT 3 BIDDERS QUALIFICATION STATEMENT Project: RFP No. Contractor: Indicate One: Sole Proprietor Partnership Corporation Joint Venture Other Name: Partner: Title: Title: Address: Address: City: City: State & Zip: State & Zip: Phone: Phone: State and Date of Incorporation, Partnership, Ownership, Etc. Location of Principal Office: Contact and Phone at Principal Office: Liability Insurance Provider and Limits of Coverage: Workers Compensation Insurance Provider: Address: Contact and Phone:

25 EXHIBIT 4 NO BID RESPONSE Please denote below the reason for not bidding on the above RFP:

26 EXHIBIT 5 SUPPLEMENTAL INFORMATION Please provide the following information for contract development: Is the company a 1 Sole Proprietorship Yes No 2. General Partnership Yes No 3. Limited Partnership Yes No 4. Corporation Yes No 5. Other Yes No If the company is a sole proprietorship, please list the owner's full legal name, the name under which business is conducted (i.e. d/b/a), the address for the company, including the state and county in which your business is located: If the company is a general partnership, please list the exact name of the partnership, whether it is a partnership formed under the laws of the State of Texas or another state, the business address for the partnership, including the state and county, and list of the names of all of the partners for the partnership: If the company is a limited partnership, please list the exact name of the limited partnership, whether it is a limited partnership formed under the laws of the State of Texas or another state, the business address for the limited partnership, including the state and county, and list the names of all the general partners for the partnership: If the company is a corporation, please list the exact name of the corporation, whether it is a corporation formed under the laws of the State of Texas or another state, the business address for the corporation, including the state and county, and list the names of all of the officers for the corporation: If the company is another entity not listed above, please list the exact name and type of company, the state under which it is formed, the business address for the company, including the state and county, and list the names of all of the persons authorized to act on the company's behalf: Is the company a minority, or woman owned business enterprise? No Yes if yes, specify: MBE WBE

27 Has the company been certified as a minority/woman owned business by any governmental agency? No Yes

28 EXHIBIT 6 BID BOND NOTICE: A Bond is not required for this Proposal.

29 CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session. This questionnaire is being filed in accordance with Chapter 176, Local Government Code by a person who has a business relationship as defined by Section (1-a) with a local governmental entity and the person meets requirements under Section (a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section , Local Government Code. A person commits an offense if the person knowingly violates Section , Local Government Code. An offense under this section is a Class C misdemeanor. FORM CIQ OFFICE USE ONLY Date Received 1 Name of person who has a business relationship with local governmental entity. 2 Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3 Name of local government officer with whom filer has employment or business relationship. Name of Officer This section (item 3 including subparts A, B, C & D) must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section (1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the filer of the questionnaire? Yes No B. Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? Yes No C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? Yes No D. Describe each employment or business relationship with the local government officer named in this section. 4 Signature of person doing business with the governmental entity Date Adopted 06/29/2007