REQUEST FOR PROPOSAL (RFP) FOR FUEL CARD PROGRAM PROPOSAL #

Size: px
Start display at page:

Download "REQUEST FOR PROPOSAL (RFP) FOR FUEL CARD PROGRAM PROPOSAL #2013-36"

Transcription

1 REQUEST FOR PROPOSAL (RFP) FOR FUEL CARD PROGRAM PROPOSAL # Issued by: Prtage Cunty Purchasing Department Prpsals must be submitted N later than 2:00 PM 7/31/2013 t: Prtage Cunty Purchasing 1462 Strngs Ave Stevens Pint WI LATE PROPOSALS WILL BE REJECTED There will nt be a public pening fr this Prpsal Fr further infrmatin regarding this RFP cntact Matthew Fleming At (715) flemingm@c.prtage.wi.us Issued: 7/01/2013

2 Table f Cntents 1. General Infrmatin Intrductin Definitins Scpe Calendar f Events Cntract Term and Funding Preparing and Submitting a Prpsal General Instructins Incurring Csts Submitting Prpsals Prpsal Organizatin and Frmat Multiple Prpsals Withdrawal f Prpsals Prpsal Selectin and Award Prcess Evaluatin Cmmittee Preliminary Evaluatin Right t reject prpsals Prpsal Scring Evaluatin Criteria Interviews/Presentatins and/r Site Visits Final Evaluatin Award and Final Offers Ntificatin f Intent t Award Appeals Prcess Negtiate Cntract Terms Requirements Mandatry Requirements Cntract Requirements Prpser Infrmatin and Slutins Organizatin Capabilities Staff Qualificatins Prpser Slutins Prpser References... 11

3 Table f Cntents 6. Cst Prpsal General Instructins fr the Cst Prpsal and hw it will be Scred Frmat fr Submitting Cst Prpsal Fixed Price Perid Attachment A - Signature and Authrity Affidavit Frm Attachment B - References Attachment C - Designatin f Cnfidential & Prprietary Infrmatin Frm Attachment D - Mandatry Requirements Attachment E - Standard Terms and Cnditins Attachment F - Cst Prpsal

4 Page 4 f General Infrmatin 1.1. Intrductin The purpse f this dcument is t prvide interested parties with infrmatin t enable them t prepare and submit a prpsal fr a fuel card prgram t allw the Prtage Cunty Fleet t purchase fuel at varius filling statins thrughut Prtage Cunty and the State f Wiscnsin. The Cunty f Prtage as represented by the Purchasing Department intends t use the results f this Request fr Prpsal (RFP) t award a cntract fr the abve listed prject. The cntract administratr will be determined at the time f the cntract award. Retain a cpy f these prpsal dcuments fr yur files. Shuld yu receive an award, these dcuments becme yur cntract terms and cnditins Definitins The fllwing definitins are used thrughut the RFP: Cntractr means prpser awarded the cntract. Cunty means the Cunty f Prtage Wiscnsin. Prpser/Vendr/Bidder means a cmpany r individual submitting a prpsal in respnse t this RFP. Purchasing means the Cunty f Prtage Purchasing Department. RFP means Request fr Prpsal. State means the State f Wiscnsin. VendrNet means the State f Wiscnsin s electrnic purchasing infrmatin system Scpe Prject Descriptin The Fuel Card Prgram prvides apprximately 80 fuel cards fr varius Cunty vehicles frm departments such as Sheriff, Ambulance, Aging & Disability Resurce Center, Aut Pl, Facilities, Health Care Center, Land Cnservatin, Library, and the Crner. The Cunty purchases apprximately 12,000 gallns f diesel (mixture f #2 and winter blend) and 68,000 f 87 ctane unleaded gasline annually. The Cunty als makes eight t ten purchases f fuel gift cards in $5.00 and $10.00 increments fr use by Cunty prgram participants, ttaling apprximately $10,000 t $12,000 annually. Quantities listed are nly an estimate; the actual quantity purchased r cards issued may be mre r less Objective/Needs The Cunty requires a Fuel Card Prgram that allws the purchase f quality unleaded and diesel fuels at varius lcatins in Prtage Cunty and the State f Wiscnsin. The Fuel Card Prgram must have rbust reprting capabilities that are accessible nline t assist the Cunty in tracking fuel use thrughut the fleet and accurate billing detail fr ease f payment and recnciliatin Histry and Backgrund The Fuel Card Prgram has been in place fr 15+ years prviding fuel fr Cunty fleet vehicles. Frm time t time, the Cunty will prduce a cmpetitive bid r prpsal at the end f a cntract term t allw fr pen and fair cmpetitin frm the varius fuel card prviders. Currently sme departments issue a fuel card fr each vehicle and each driver receives a Driver ID (PIN) t track fuel purchases. Other departments issue a fuel card fr each vehicle with a single PIN fr each vehicle.

5 Page 5 f Clarificatins and/r Revisins t this RFP Prtage Cunty Purchasing is the sle pint f cntact fr the Cunty during the selectin prcess. Cntact with anyne else invlved with this prcess withut the prir authrizatin f Purchasing may result in the disqualificatin f yur prpsal. Prpsers are expected t raise any questins, nted errrs, discrepancies, ambiguities, exceptins, additins r deficiencies they have cncerning this prpsal in writing thrugh by 7/15/2013, t: Matthew Fleming, Purchasing, flemingm@c.prtage.wi.us If a prpser discvers any significant ambiguity, errr, cnflict, discrepancy, missin, r ther deficiency in this prpsal after the abve date, they shall immediately ntify the abve named individual f such errr and request mdificatin r clarificatin f the prpsal dcument befre the prpsal pening date. If the prpser fails t ntify the Cunty prir t the prpsal due date f any cnditin stated abve that reasnably shuld have been knwn t the prpser, and if a cntract is awarded t that prpser, the prpser shall nt be entitled t additinal cmpensatin r time by reasn f the errr r its crrectin. Revisins t this request fr prpsal r answers t questins will be made nly by an fficial written addendum issued by Purchasing. Addenda will be psted n VendrNet and n the Prtage Cunty Website. Prpsers are respnsible fr checking these websites fr any addenda befre submitting a prpsal. Failure t acknwledge addenda may disqualify yur prpsal Calendar f Events Listed belw are specific and estimated dates and times f actins related t this Request fr Prpsal. The actins with specific dates must be cmpleted as indicated unless therwise changed by the Cunty. In the event that the Cunty finds it necessary t change any f the specific dates and times, it will d s by issuing addenda t this RFP. There may r may nt be a frmal ntificatin issued fr changes f the estimated dates and times. DATE EVENT 7/1/2013 RFP Issuance date 7/15/2013 Last day fr submitting written questins 7/19/2013 Addenda psted t and 7/31/2013 Prpsals due at r befre 2:00 p.m. 8/27/2013 Interviews/Presentatins (estimated date if needed) 8/28/2013 Ntificatin f intent t award sent t prpsers (estimated) 9/17/2013 Cntract award (estimated) 11/1/2013 Distribute and Activate Cards (estimated) 1.5. Cntract Term and Funding The cntract shall be effective n the award date f the cntract and shall cntinue fr three years frm that date. The cntract may be extended by mutual agreement f the Cunty and the Cntractr.

6 Page 6 f Preparing and Submitting a Prpsal 2.1. General Instructins The evaluatin and selectin f a cntractr will be based n the infrmatin submitted in the prpsal plus references and any required n-site visits, interviews/presentatins r demnstratins. Prpsers shuld respnd clearly and cmpletely t all requirements. Failure t respnd t each f the requirements in the RFP may be the basis fr rejecting a prpsal. Elabrate prpsals (e.g. expensive artwrk), beynd that sufficient t present a cmplete and effective prpsal, are nt necessary r desired. The Cunty encurages all prpsers t print their submissin duble-sided t save paper Incurring Csts The Cunty is nt liable fr any cst incurred by prpsers in replying t this RFP Submitting Prpsals Prpsers must submit, in a sealed package, One Original (identify) PLUS FOUR cpies f all materials required fr acceptance f their prpsal n r befre 2:00 p.m., 7/31/2013 t: Prtage Cunty Purchasing 1462 Strngs Ave Stevens Pint, WI All prpsals must be received by the Purchasing Department by the stated time. Late prpsals will nt be accepted. Receipt f the prpsal by the U.S. mail system des nt cnstitute receipt f the prpsal by Purchasing. The Cunty des nt accept facsimile machine r submitted prpsals. All prpsals must be packaged, sealed, and shw the fllwing infrmatin n the utside f the package: Prpser's Name and Address Request fr Prpsal Title Request fr Prpsal Number Prpsal Due Date COST PROPOSAL: Submit Original plus ne (1) cpy Attachment F. Seal in an envelpe and submit within the prpsal package. The utside f the envelpe shuld clearly state Cst Prpsal and the name f prpser Prpsal Organizatin and Frmat Prpsal shuld be typed and submitted n 8.5 by 11 inch paper and bund securely with page numbers clearly indicated. Prpsers respnding t this RFP must cmply with the fllwing frmat requirements: Tab 1 - COVER LETTER, RFP SIGNATURE PAGES: Include here any cver letter, Attachment A - RFP Signature and Authrity Affidavit Frm, any addenda signature pages, and Attachment C - Designatin f Cnfidential & Prprietary Infrmatin Frm.

7 Page 7 f 20 The Signature and Authrity Affidavit submitted in respnse t this RFP must be signed by the persn in the Prpser's rganizatin wh is respnsible fr the decisin as t the prices being ffered r by a persn wh has been authrized in writing t act as agent fr the persn respnsible fr the decisin n prices and services. Failure t prvide these frms/infrmatin with yur bid submittal may disqualify yur prpsal. Tab 2 - RESPONSE TO PROPOSER INFORMATION AND SOLUTIONS: Respnses t the requirements in the prpser infrmatin and slutins must be in the same sequence and numbered as they appear in this RFP. Include here cmpleted Attachment B--References. Tab 3 MANDATORY REQUIREMENTS: Include Attachment D Mandatry Requirements. Separate Envelpe - COST PROPOSAL ATTACHMENT F: Prvide cst infrmatin as detailed in Sectin 6 in this RFP. All csts, as requested, fr furnishing the prduct(s) and/r service(s) must be included in this prpsal. The cst prpsal must NOT be listed in any ther part f the prpsal respnse Multiple Prpsals Multiple prpsals frm a prpser will be permissible; hwever each prpsal must cnfrm fully t the requirements fr prpsal submissin. Each such prpsal must be separately submitted and labeled as Prpsal #1, Prpsal #2, etc. n each page included in the respnse 2.6. Withdrawal f Prpsals Prpsals shall be irrevcable until cntract award unless the prpsal is withdrawn. Prpsers may withdraw a prpsal, in writing, at any time up t the prpsal due date and time r upn expiratin f 180 days after the due date and time. The written withdrawal ntice must be received by Purchasing. The ntice must be signed by an authrized representative f the prpser. If a previusly submitted prpsal is withdrawn befre the prpsal due date and time, the prpser may submit anther prpsal at any time up t the prpsal due date and time. 3. Prpsal Selectin and Award Prcess 3.1. Evaluatin Cmmittee The Cunty s evaluatin cmmittee will cnsist f members wh have been selected because f their special expertise and knwledge f the service(s) and/r prduct(s) that are the subject f this RFP. Prpsers may nt cntact members f the evaluatin cmmittee except at the request f the Purchasing Department Preliminary Evaluatin The prpsals will be initially reviewed t determine if mandatry requirements are met. Failure t meet mandatry requirements shall result in the prpsal being rejected. In the event that all prpsers d nt meet ne r mre f the mandatry requirements, the Cunty reserves the right t cntinue the evaluatin f the prpsals that mst clsely meet the mandatry requirements f this RFP Right t reject prpsals The Cunty reserves the right t reject any and all prpsals.

8 Page 8 f Prpsal Scring Accepted prpsals will be reviewed by an evaluatin cmmittee and scred against the stated criteria. The cmmittee may review references, request interviews/presentatins, cnduct demnstratins and/r cnduct n-site visits. The resulting infrmatin will be used t scre the prpsals. The evaluatin cmmittee's scring will be tabulated and prpsals ranked based n the numerical scres received Evaluatin Criteria The prpsals will be scred using the fllwing criteria: Descriptin Pints Organizatin Capabilities 100 Staff Qualificatins 100 Prpser Slutins 550 Cst Prpsal 250 Ttal Interviews/Presentatins and/r Site Visits Tp-scring prpsers, based n the evaluatin f the written prpsal, may be required t have interviews/presentatins t supprt and clarify their prpsals, if requested by the Cunty. The Cunty will make every reasnable attempt t schedule the interview/presentatin n the date specified in the Calendar f Events. Failure f a prpser t cmplete a scheduled interview/presentatin t the Cunty may result in rejectin f that prpser's prpsal. The Cunty may cnduct site visits f prpser and/r references facilities t clarify r cnfirm prpsal infrmatin Final Evaluatin Upn cmpletin f any interviews/presentatins and/r demnstratins by prpsers, the Cunty's evaluatin team will review their evaluatins and make adjustments t the scres based n the infrmatin btained in the interview/presentatin, demnstratin, pssible reference checks, and any ther pertinent prpser infrmatin Award and Final Offers Award will be granted in ne f tw ways. The award may be granted t the highest scring respnsive and respnsible prpser after the riginal evaluatin prcess is cmplete. Alternatively, the highest prpser r prpsers may be requested t submit best and final ffers. If the Cunty requests best and final ffers, they will be evaluated against the stated criteria, scred, and ranked by the evaluatin cmmittee. The award will then be granted t the highest scring prpser fllwing that prcess. Hwever, a prpser shuld nt expect that the Cunty will request a best and final ffer Ntificatin f Intent t Award All prpsers wh respnd t this RFP will be ntified in writing f the Cunty's intent t award the cntract(s) as a result f this RFP.

9 Page 9 f Appeals Prcess Ntices f intent t prtest and prtests must be made in writing. Prtestrs shuld make their prtests as specific as pssible and shuld identify Wiscnsin Statutes r Prtage Cunty Ordinance prvisins that are alleged t have been vilated. The written ntice f intent t prtest the intent t award a cntract must be filed with Matthew Fleming, Prcurement Directr, Prtage Cunty Wiscnsin, 1462 Strngs Ave, Stevens Pint, WI 54481, and received in his ffice n later than five (5) wrking days after the ntice f intent t award is issued. The written prtest must be received in his ffice n later than ten (10) wrking days after the ntice f intent t award is issued. The decisin f the Prcurement Directr may be appealed t the Crpratin Cunsel Office within (5) wrking days f issuance. The appeal must allege a vilatin f a Wiscnsin Statute r a Prtage Cunty Ordinance prvisin Negtiate Cntract Terms The Cunty reserves the right t negtiate the terms f the cntract, including the award amunt, with the selected prpser prir t entering int a cntract. If cntract negtiatins cannt be cncluded successfully with the highest scring prpser, the Cunty may negtiate a cntract with the next highest scring prpser. 4. Requirements 4.1. Mandatry Requirements Submit respnse using Attachment D Mandatry Requirements under Tab 3 f prpsal - see sectin 2.4 fr prpsal submittal frmat. The fllwing requirement(s) are mandatry and the prpser must satisfy them as a pass/fail pre-screening requirement. Any prpsal submitted nt in cmpliance with mandatry requirements will be rejected and nt evaluated r scred Fuel Card Prgram must autmatically remve Federal Taxes and any applicable Sales Tax in which the Cunty is exempt Fuel Card service must nt be disrupted r put n hld withut a 20 day written ntice t the Cunty Cntract Requirements The awarded cntractr is expected t fulfill the fllwing cntract requirements Cntractr shall have multiple filling statins available in Prtage Cunty and thrughut the State f Wiscnsin. Filling statins must have fuel available and pay at the pump features pen 24 hurs a day, 7 days a week, 365 days a year. Filling statins must be able t service a wide variety f vehicles includes cards, trucks and busses.

10 Page 10 f Fuels must meet r exceed all Federal, State, Lcal, and autmtive manufacturer s standards including Wiscnsin Administrative Cde Chapter SPS 348 Petrleum and Other Liquid Fuel Prducts. The Fuel Card Prgram must be in accrdance with all applicable laws, cdes and rdinances. Standard 87 ctane unleaded, #2 diesel, and winter blend diesel must be available Fuel cards must cllect the fllwing data at the pump, depending n the card setup. Itemized mnthly billing must be accurate and include the infrmatin cllected at the pump fr each transactin Date, time, and lcatin f purchase Type f fuel purchased Number f gallns purchased Price per galln Identify f the fuel card used Vehicle mileage Driver ID r PIN used The fllwing reprting capabilities must be available at a minimum and accessible nline r received autmatically via Reprt listing each card use detail included prducts purchased, dates, times, etc Reprt listing fuel ecnmy mileage calculatins fr each card r vehicle ID (if used) Reprt listing Driver ID r PIN activity with detail n prducts purchased, dates, times, etc Reprt listing purchasing activity and discunts State Sales Tax Reprt Fuel cards must be capable f limiting purchases t fuel nly n mst cards and fuel and gift card purchases n thers Billing fr fuel cards must be itemized fr each fuel card, by department, and reflect date, time, Driver ID r PIN, gallns purchased, type f fuel, dmeter reading, and calculated miles per galln Applicatins fr new fuel cards r cancellatin f exiting cards must be able t be cmpleted nline r via . Lead time fr new cards shall nt exceed 5 business days. Cards shall nt be activated until receipt is cnfirmed by the Cunty. Cancellatin f cards shall be immediate Fuel gift cards must be available fr purchase in $5.00 and $10.00 increments fr use by prgram participants Subcntractrs The Cntractr shall be respnsible fr Cntract perfrmance when subcntractrs are used. Hwever, when subcntractrs are used, they must abide by all terms and cnditins f the Cntract. If subcntractrs are t be used, the Cntractr must clearly explain their participatin.

11 Page 11 f Prpser Infrmatin and Slutins Submit respnse under Tab 2 f prpsal - see sectin 2.4 fr prpsal submittal frmat Organizatin Capabilities Describe the rganizatin/cmpany's experience and capabilities prviding similar services t thse required. Be specific and detail n mre than three prjects/cntracts: descriptin f wrk, dates, lcatins, challenges and results. (100 Pints) 5.2. Staff Qualificatins Identify key staff yur rganizatin/cmpany will assign t fulfill the cntract requirements and manage the accunt. Prvide a synpsis describing the educatinal and wrk experience fr each f the key staff wh wuld be assigned t the prgram and a descriptin f their duties. Detail the number f hurs fr each key staff member that yu estimate will be needed t fulfill the cntract requirements. (100 Pints) 5.3. Prpser Slutins Describe yur Fuel Card Prgram and hw it will meet r exceed Cunty needs as defined in the scpe and requirements sectin f this RFP. Describe yur methd f custmer supprt, cmmunicatin, and ability t supprt effective management f the prgram. (150 Pints) Prvide a list f the filling statin lcatins specifically in Prtage Cunty and thrughut Wiscnsin. Prvide the hurs f peratin fr each lcatin. List if 87 ctane unleaded, diesel, r bth fuels are available. Include any alternative fuels that are available at each lcatin such as E85, Bidiesel, CNG, etc. (200 Pints) Describe the reprting capabilities f the Fuel Card Prgram. Describe the standard reprts and ability t custmize reprts. Describe the accessibility f the reprts nline, hw many users are able t create, review and custmize reprts, and user definable limits. (100 Pints) Describe yur firm s ability t detect and cmbat waste, fraud and abuse. Describe the prcess and lead time fr card cancellatin, yur firm s ability t investigate misuse, and recvery f fraudulent charges. (100 Pints) 5.4. Prpser References Submit respnse using Attachment B References under Tab 2 f prpsal see sectin 2.4 fr prpsal submittal frmat. Prpser must supply references f three firms t which similar prducts/service have been prvided within the past five years t a cmparable sized institutin r cmpany. If cntacted, all f thse references must verify that a high level f satisfactin was prvided. 6. Cst Prpsal 6.1. General Instructins fr the Cst Prpsal and hw it will be Scred Purchasing will scre the cst prpsals by prrating the ttal estimated annual discunt with the highest ttal given the highest scre. The frmula is as fllws: (Prpsed ttal discunt / Highest prpsed discunt) X Maximum Pints assigned t Cst = Scre

12 Page 12 f Frmat fr Submitting Cst Prpsal. Use Attachment F Cst Prpsal. Submit ne marked riginal plus ne cpy. Seal in an envelpe and submit within the prpsal package. The utside f the envelpe shuld clearly state Cst Prpsal and the name f prpser Fixed Price Perid The awarded cntractr must hld the accepted prices and/r csts fr the entire cntract perid. Any adjustment t prices and/r csts at the beginning f a cntract renewal perid will be negtiated between the Cunty and the Cntractr.

13 Page 13 f 20 ATTACHMENT A SIGNATURE AND AUTHORITY AFFIDAVIT FORM PROPOSING COMPANY NAME: FEIN (Federal Emplyer ID Number) OR Scial Security # (if Sle Prprietrship) Address: City State Zip + 4 Number f years in Business Name the persn t cntact fr questins cncerning this prpsal. Name Title Phne ( ) Tll Free Phne ( ) Fax ( ) Address In signing this prpsal, we als certify that we have nt, either directly r indirectly, entered int any agreement r participated in any cllusin r therwise taken any actin in restraint f free cmpetitin; that n attempt has been made t induce any ther persn r firm t submit r nt t submit a prpsal; that this prpsal has been independently arrived at withut cllusin with any ther prpser, cmpetitr r ptential cmpetitr; that this prpsal has nt been knwingly disclsed prir t the pening t any ther prpser r cmpetitr; that the abve statement is accurate under penalty f perjury. The undersigned, having familiarized themselves with the cnditins affecting the cst f the wrk, having read cmpletely the requirements, hereby prpses t perfrm everything required and t prvide and furnish labr, materials, equipment, tls and all ther services and supplies necessary t prduce in a cmplete and wrkmanlike manner all f the materials r prducts described in the prject relating t this prpsal. I further certify that I have carefully examined the prpsal dcuments and all terms herein, and site where the wrk is t be dne and have n agreements t prevent the cmpletin f said wrk. Signature Name (type r print) Title Date This firm herby acknwledges receipt / review f the fllwing addendum(s) (If any) Addendum # Addendum # Addendum # Addendum #

14 Page 14 f 20 ATTACHMENT B REFERENCES Prpser: Prvide cmpany name, address, cntact persn, telephne number, and apprpriate infrmatin n the prduct(s) and/r service(s) prvided t custmers similar t thse requested in this slicitatin dcument. Ptential subcntractrs cannt be references. Any subcntractr arrangement fr the cmpletin f this wrk shall be listed n a separate page. Cmpany Name: Address (include Zip + 4) Cntact Persn: Phne N. Address: Prduct(s) Used and/r Service(s) Prvided: Cmpany Name: Address (include Zip + 4) Cntact Persn: Phne N. Address: Prduct(s) Used and/r Service(s) Prvided: Cmpany Name: Address (include Zip + 4) Cntact Persn: Phne N. Address: Prduct(s) Used and/r Service(s) Prvided: Cmpany Name: Address (include Zip + 4) Cntact Persn: Phne N. Address: Prduct(s) Used and/r Service(s) Prvided:

15 Page 15 f 20 ATTACHMENT C DESIGNATION OF CONFIDENTIAL AND PROPRIETARY INFORMATION The attached material submitted in respnse t Bid/Prpsal # includes prprietary and cnfidential infrmatin which qualifies as a trade secret, as prvided in s (5), Wis. Stats., r is therwise material that can be kept cnfidential under the Wiscnsin Open Recrds Law. As such, we ask that certain pages, as indicated belw, f this bid/prpsal respnse be treated as cnfidential material and nt be released withut ur written apprval. Prices always becme public infrmatin when bids/prpsals are pened, and therefre cannt be kept cnfidential. Other infrmatin cannt be kept cnfidential unless it is a trade secret. Trade secret is defined in s (1)(c), Wis. Stats. as fllws: "Trade secret" means infrmatin, including a frmula, pattern, cmpilatin, prgram, device, methd, technique r prcess t which all f the fllwing apply: 1. The infrmatin derives independent ecnmic value, actual r ptential, frm nt being generally knwn t, and nt being readily ascertainable by prper means by, ther persns wh can btain ecnmic value frm its disclsure r use. 2. The infrmatin is the subject f effrts t maintain its secrecy that are reasnable under the circumstances. We request that the fllwing pages nt be released: Sectin Page # Tpic IN THE EVENT THE DESIGNATION OF CONFIDENTIALITY OF THIS INFORMATION IS CHALLENGED, THE UNDERSIGNED HEREBY AGREES TO PROVIDE LEGAL COUNSEL OR OTHER NECESSARY ASSISTANCE TO DEFEND THE DESIGNATION OF CONFIDENTIALITY AND AGREES TO HOLD THE STATE HARMLESS FOR ANY COSTS OR DAMAGES ARISING OUT OF THE COUNTY'S AGREEING TO WITHHOLD THE MATERIALS. Failure t include this frm in the bid/prpsal respnse may mean that all infrmatin prvided as part f the bid/prpsal respnse will be pen t examinatin and cpying. The Cunty cnsiders ther markings f cnfidential in the bid/prpsal dcument t be insufficient. The undersigned agrees t hld the Cunty harmless fr any damages arising ut f the release f any materials unless they are specifically identified abve. Cmpany Name Authrized Representative Signature Authrized Representative Type r Print Date

16 Page 16 f 20 ATTACHMENT D MANDATORY REQUIREMENTS Prpser: Fuel Card Prgram autmatically remves Federal Taxes and Sales Taxes in which the Cunty is exempt? Yes N Fuel Card service will nt be disrupted r put n hld withut a 20 day written ntice t the Cunty. Yes N

17 Page 17 f 20 ATTACHMENT E STANDARD TERMS AND CONDITIONS HOW TO AMEND A REQUEST FOR PROPOSAL/BID/QUOTATION BEFORE DUE DATE AND TIME: After a Request fr Bid/Prpsal/Qute (hereinafter referred t as bid/bidder) has been filed with the Prtage Cunty Purchasing Department (hereinafter referred t as Cunty), the respnder desires t amend the bid, BIDDER MAY DO SO BEFORE THE DUE DATE AND TIME set fr the receipt f bids in the Request fr Bid by filing an amendment fully identified with the riginal bid submitted by cmmdity r service. All the cnditins and prvisins f the riginal bid will be in effect. NO REQUESTS FOR BID OR AMENDMENTS WILL BE ACCEPTED AFTER THE DUE DATE AND TIME FOR RECEIPT OF BIDS AS SPECIFIED IN THE REQUEST FOR BID. This des nt preclude the Cunty frm requesting additinal infrmatin and/r clarificatin. SPECIFICATIONS: The specificatins in this request are the minimum acceptable. When specific manufacturer and mdel numbers are used, they are t establish a design, type f cnstructin, quality, functinal capability and/r perfrmance level desired unless therwise specified. When alternates are bid/prpsed, they must be identified by manufacturer, stck number, and such ther infrmatin necessary t establish equivalency. The Cunty f Prtage shall be the sle judge f equivalency. QUALITY: Unless therwise indicated in the request, all material shall be new, newest mdel year, and free frm defects. Items which are used, demnstratrs, bslete, secnds, r which have been discntinued are unacceptable withut prir written apprval by the Cunty. QUANTITIES: The quantities shwn n this request are based n estimated needs. The Cunty reserves the right t increase r decrease quantities t meet actual needs. CONTRACT AND EXECUTION OF CONTRACT: Unless therwise specified in the Bid, the successful respnder agrees t enter int the cntract n the frm prepared by the Cunty, a cpy f which will be n file in the ffice f the Prtage Cunty Purchasing Department. DELAYS IN DELIVERY: Delays in delivery caused by any bna fide strikes, gvernment pririty f requisitin, rits, fires, sabtage, acts f Gd, r any ther delays deemed by the Cunty t be clearly and unequivcally beynd the cntractr's cntrl will be recgnized by the Cunty. The cntractr may be relieved f the respnsibility f meeting the delivery time as stipulated in the cntract upn cntractr's filing with the Cunty s just and true statements requesting an extensin f delivery, signed by the cntractr and giving in detail all the essential circumstances which, upn verificatin by the Cunty, justify such actin under the prvisins f this sectin by the Cunty. FAIR EMPLOYMENT PRACTICES: All Bids shall be subject t the prvisins f Wiscnsin State Statutes relating t prhibitin f discriminatin in emplyment. This prvisin shall be applicable and incrprated as part f any cntract r bid award. NON-DISCRIMINATION: In perfrming in accrdance with the terms f the Bid, the cntractr agrees nt t discriminate against any qualified emplyee r qualified applicant fr emplyment because f sex, race, religin, clr, natinal rigin r ancestry, age, disability, lawful surce f incme, marital status, sexual rientatin, gender identity r expressin, past r present membership in the military service, familial status, r based upn affiliatin with, r perceived affiliatin with any f these prtected categries as defined in Wiscnsin State Statutes. Cntractr is required t include a similar prvisin in all subcntracts. This prvisin shall include, but nt be limited t, the fllwing: emplyment, upgrading, demtin r transfer, recruitment r recruitment advertising, lay-ff r terminatin, rates f pay r ther frms f cmpensatin, and selectin fr training, including apprenticeship. The cntractr further agrees t take affirmative actin t insure equal emplyment pprtunities fr persns with disabilities. The cntractr agrees t pst in cnspicuus places available fr emplyees and applicants fr emplyment ntices t be prvided by the cntracting fficer setting fr the prvisins f the nndiscriminatin clause.

THIRD PARTY PROCUREMENT PROCEDURES

THIRD PARTY PROCUREMENT PROCEDURES ADDENDUM #1 THIRD PARTY PROCUREMENT PROCEDURES NORTH CENTRAL TEXAS COUNCIL OF GOVERNMENTS TRANSPORTATION DEPARTMENT JUNE 2011 OVERVIEW These prcedures establish standards and guidelines fr the Nrth Central

More information

Bill Payment Agreement & Disclosures

Bill Payment Agreement & Disclosures Bill Payment Agreement & Disclsures Welcme t Online Banking Bill Payment Service. Use f the Bill Payment Service indicates acceptance f terms and cnditins set frth in the Online Banking Agreement & Disclsures

More information

REQUEST FOR PROPOSALS FOR Liability, Workman s Compensation, Automobile & Property Insurance Proposals Due: July 3, 2012

REQUEST FOR PROPOSALS FOR Liability, Workman s Compensation, Automobile & Property Insurance Proposals Due: July 3, 2012 LifeWays Cmmunity Mental Health 1200 N. West Avenue Jacksn, Michigan 49202 517.789.1200 REQUEST FOR PROPOSALS FOR Liability, Wrkman s Cmpensatin, Autmbile & Prperty Insurance Prpsals Due: July 3, 2012

More information

NAIC Replacement Requirements For Certain Life Insurance Policies And Annuity Contracts

NAIC Replacement Requirements For Certain Life Insurance Policies And Annuity Contracts NAIC Replacement Requirements Fr Certain Life Insurance Plicies And Annuity Cntracts Duties f Prducers If a transactin invlves a replacement, the prducer must leave with the applicant, at the time an applicatin

More information

REQUEST FOR PROPOSAL FOR WEBSITE DESIGN CONTRACT SERVICES

REQUEST FOR PROPOSAL FOR WEBSITE DESIGN CONTRACT SERVICES REQUEST FOR PROPOSAL FOR WEBSITE DESIGN CONTRACT SERVICES The Yl-Slan Air Quality Management District (District) is currently sliciting prpsals fr cntract services t redesign its existing website: www.ysaqmd.rg

More information

FINANCIAL OPTIONS. 2. For non-insured patients, payment is due on the day of service.

FINANCIAL OPTIONS. 2. For non-insured patients, payment is due on the day of service. FINANCIAL OPTIONS 1. Fr thse patients wh carry dental insurance, all c-payments are due n date f service. We will file yur claim as a service t yu, and will d ur very best t maximize yur benefits. We accept

More information

HIPAA Notice of Privacy Practices. Central Ohio Surgical Associates, Inc.

HIPAA Notice of Privacy Practices. Central Ohio Surgical Associates, Inc. HIPAA Ntice f Privacy Practices Central Ohi Surgical Assciates, Inc. THIS NOTICE OF PRIVACY PRACTICES (THE NOTICE ) DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN

More information

expertise hp services valupack consulting description security review service for Linux

expertise hp services valupack consulting description security review service for Linux expertise hp services valupack cnsulting descriptin security review service fr Linux Cpyright services prvided, infrmatin is prtected under cpyright by Hewlett-Packard Cmpany Unpublished Wrk -- ALL RIGHTS

More information

Merchant Processes and Procedures

Merchant Processes and Procedures Merchant Prcesses and Prcedures Table f Cntents EXHIBIT C 1. MERCHANT INTRODUCTION TO T-CHEK 3 1.1 Wh is T-Chek Systems? 3 1.2 Hw t Cntact T-Chek Systems 3 1.3 Hw t Recgnize T-Chek Frms f Payment 3 1.3.1

More information

Request for Resume (RFR) CATS II Master Contract. All Master Contract Provisions Apply

Request for Resume (RFR) CATS II Master Contract. All Master Contract Provisions Apply Sectin 1 General Infrmatin RFR Number: (Reference BPO Number) Functinal Area (Enter One Only) F50B3400026 7 Infrmatin System Security Labr Categry A single supprt resurce may be engaged fr a perid nt t

More information

CCPRF. Request for Proposals. Monitoring Services. November 25, 2009

CCPRF. Request for Proposals. Monitoring Services. November 25, 2009 CCPRF Request fr Prpsals Mnitring Services Nvember 25, 2009 Table f Cntents SECTION I... 1 1.1 INTRODUCTION AND OPPORTUNITY... 1 1.2 OBJECTIVES OF RFP... 1 1.3 STATEMENT OF WORK... 1 SECTION II... 2 2.1

More information

Purchasing Policy Checklist for Procurement with Federal Grants Eileen Youens, JD

Purchasing Policy Checklist for Procurement with Federal Grants Eileen Youens, JD Purchasing Plicy Checklist fr Prcurement with Federal Grants Eileen Yuens, JD T cmply with the Unifrm Administrative Requirements, Cst Principles, and Audit Requirements fr Financial Awards (the Super

More information

REQUEST FOR PROPOSAL SECURITY SERVICES

REQUEST FOR PROPOSAL SECURITY SERVICES REQUEST FOR PROPOSAL SECURITY SERVICES Sectin I INTRODUCTION [Cmpany] is seeking prpsals frm qualified Cntractrs t prvide unifrmed security service fr [Cmpany] facilities at [Lcatin(s)]. This dcument is

More information

THE CITY UNIVERSITY OF NEW YORK IDENTITY THEFT PREVENTION PROGRAM

THE CITY UNIVERSITY OF NEW YORK IDENTITY THEFT PREVENTION PROGRAM THE CITY UNIVERSITY OF NEW YORK IDENTITY THEFT PREVENTION PROGRAM 1. Prgram Adptin The City University f New Yrk (the "University") develped this Identity Theft Preventin Prgram (the "Prgram") pursuant

More information

Frequently Asked Questions About I-9 Compliance

Frequently Asked Questions About I-9 Compliance Frequently Asked Questins Abut I-9 Cmpliance What is required t verify wrk authrizatin? The basic requirement t verify wrk authrizatin is the Frm I-9. This frm is available n the HR website: http://www.fit.edu/hr/dcuments/frms/i-9.pdf

More information

CENTURIC.COM ONLINE DATA BACKUP AND DISASTER RECOVERY SOLUTION ADDENDUM TO TERMS OF SERVICE

CENTURIC.COM ONLINE DATA BACKUP AND DISASTER RECOVERY SOLUTION ADDENDUM TO TERMS OF SERVICE CENTURIC.COM ONLINE DATA BACKUP AND DISASTER RECOVERY SOLUTION ADDENDUM TO TERMS OF SERVICE This Agreement, named the Online Data Backup and Disaster Recvery Slutin Addendum t Centuric s Terms f Service

More information

Multi-Year Accessibility Policy and Plan for NSF Canada and NSF International Strategic Registrations Canada Company, 2014-2021

Multi-Year Accessibility Policy and Plan for NSF Canada and NSF International Strategic Registrations Canada Company, 2014-2021 Multi-Year Accessibility Plicy and Plan fr NSF Canada and NSF Internatinal Strategic Registratins Canada Cmpany, 2014-2021 This 2014-21 accessibility plan utlines the plicies and actins that NSF Canada

More information

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM WB-DEC

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM WB-DEC UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washingtn, D.C. 20549 FORM WB-DEC DECLARATION OF ORIGINAL INFORMATION SUBMITTED PURSUANT TO SECTION 21F OF THE SECURITIES EXCHANGE ACT OF 1934 A. SUBMITTER

More information

o o 2) Program Rewards

o o 2) Program Rewards 1) T qualify fr the American Red Crss High Schl Leadership Prgram (referred t as Prgram), each student (referred t as Member) is asked t cmplete the fllwing requirements: a. Cmplete an nline prfile at

More information

Heythrop College Disciplinary Procedure for Support Staff

Heythrop College Disciplinary Procedure for Support Staff Heythrp Cllege Disciplinary Prcedure fr Supprt Staff Intrductin 1. This prcedural dcument des nt apply t thse academic-related staff wh are mentined in the Cllege s Ordinance, namely the Librarian and

More information

Purpose Statement. Objectives

Purpose Statement. Objectives Apprved by Academic Affairs Cuncil, June 24, 2014 Faculty Handbk Part VI: Other Plicies and Prcedures Sectin R. Intellectual Prperty Classified Emplyee Handbk Part VI: Other Plicies and Prcedures Sectin

More information

Application Fee Schedule Please check the appropriate box below. See also Additional Information starting on page 6.

Application Fee Schedule Please check the appropriate box below. See also Additional Information starting on page 6. DRIVING SCHOOL LICENSE APPLICATION N. APPLICATION DMV USE ONLY N. LICENSE Received Fee Amunt Expiratin Fee Amunt PART 1 Schl Infrmatin: l READ VEHICLE AND TRAFFIC LAW SECTION 394 AND DMV COMMISSIONER S

More information

Errors & Omissions Insurance for Title, Escrow Agents and Abstractors. Endorsed by the American Land Title Association

Errors & Omissions Insurance for Title, Escrow Agents and Abstractors. Endorsed by the American Land Title Association Errrs & Omissins Insurance fr Title, Escrw Agents and Abstractrs Endrsed by the American Land Title Assciatin The Insurance Cmpany: Title Industry Assurance Cmpany, a Risk Retentin Grup TIAC issued its

More information

Financial Planning Agreement

Financial Planning Agreement Financial Planning Agreement This Financial Planning Agreement, the ( Agreement ), dated as f, 20, is by and between Vulcan Investments LLC, 2100 SuthBridge Pkwy, Suite 650 Birmingham, AL. 35209, an investment

More information

Peratr Accreditatin and Services in Queensland

Peratr Accreditatin and Services in Queensland Infrmatin Bulletin PT 204/09.15 Operatr Accreditatin fr Limusine Services What is peratr accreditatin? The Transprt Operatins (Passenger Transprt) Act 1994 requires peratrs f public passenger services

More information

LOUISIANA TECH UNIVERSITY Division of Student Financial Aid Post Office Box 7925 Ruston, LA 71272

LOUISIANA TECH UNIVERSITY Division of Student Financial Aid Post Office Box 7925 Ruston, LA 71272 LOUISIANA TECH UNIVERSITY Divisin f Student Financial Aid Pst Office Bx 7925 Rustn, LA 71272 Dear Financial Aid Applicant, Accrding t yur 2011-2012 Student Aid Reprt (SAR), yu did nt include any parental

More information

Notice of Protection Provided by Utah Life and Health Insurance Guaranty Association

Notice of Protection Provided by Utah Life and Health Insurance Guaranty Association Ntice f Prtectin Prvided by Utah Life and Health Insurance Guaranty Assciatin This ntice prvides a brief summary f the Utah Life and Health Insurance Guaranty Assciatin ("the Assciatin") and the prtectin

More information

Frequently Asked Questions about the Faith A. Fields Nursing Scholarship Loan

Frequently Asked Questions about the Faith A. Fields Nursing Scholarship Loan ARKANSAS STATE BOARD OF NURSING 1123 S. University Avenue, Suite 800, University Twer Building, Little Rck, AR 72204 Phne: (501) 686-2700 Fax: (501) 686-2714 www.arsbn.rg Frequently Asked Questins abut

More information

Hampton Roads Orthopaedics & Sports Medicine. Notice of Privacy Practices

Hampton Roads Orthopaedics & Sports Medicine. Notice of Privacy Practices This is being prvided t yu as a requirement f the privacy regulatins issued under the Health Insurance Prtability and Accuntability Act f 1996 (HIPAA). This ntice describes hw HROSM may use and disclse

More information

UNO CHARTER SCHOOL NETWORK, INC. ( UCSN ) Request for Proposal ( RFP ) For. Personnel and Payroll Audit Services

UNO CHARTER SCHOOL NETWORK, INC. ( UCSN ) Request for Proposal ( RFP ) For. Personnel and Payroll Audit Services UNO CHARTER SCHOOL NETWORK, INC. ( UCSN ) Request fr Prpsal ( RFP ) Fr Persnnel and Payrll Audit Services All prpsals must be sent electrnically t: ucsnbidrespnse@uncharterschls.rg All cmmunicatins shuld

More information

We will record and prepare documents based off the information presented

We will record and prepare documents based off the information presented Dear Client: We appreciate the pprtunity f wrking with yu regarding yur Payrll needs. T ensure a cmplete understanding between us, we are setting frth the pertinent infrmatin abut the services that we

More information

ERISA Compliance FAQs: Fiduciary Responsibilities

ERISA Compliance FAQs: Fiduciary Responsibilities Brught t yu by Mrris & Reynlds Insurance ERISA Cmpliance FAQs: Fiduciary Respnsibilities The Emplyee Retirement Incme Security Act f 1974 (ERISA) is a federal law that sets minimum standards fr emplyee

More information

This regulation is adopted by the director pursuant to the authority in Neb. Rev. Stat. 44-1114.

This regulation is adopted by the director pursuant to the authority in Neb. Rev. Stat. 44-1114. Title 210 NEBRASKA DEPARTMENT OF INSURANCE Chapter 76 VIATICAL SETTLEMENTS 001. Authrity This regulatin is adpted by the directr pursuant t the authrity in Neb. Rev. Stat. 44-1114. 002. Definitins In additin

More information

This document provides instructions on how to complete the Cheque Requisition Form.

This document provides instructions on how to complete the Cheque Requisition Form. Office f the Cmptrller Accunts Payable Divisin f Finance and Administratin Standard Operating Prcedure Cheque Requisitin Effective Date: July 19, 2010 Descriptin: This dcument prvides instructins n hw

More information

Directives to LHINs in respect of Reporting Requirements under the BPSAA. Issued By Minister of Health and Long-Term Care

Directives to LHINs in respect of Reporting Requirements under the BPSAA. Issued By Minister of Health and Long-Term Care Directives t LHINs in respect f Reprting Requirements under the BPSAA Issued By Minister f Health and Lng-Term Care Effective April 1, 2011 Table f Cntents 1. BACKGROUND... 2 2. REPORT ON THE USE OF CONSULTANTS...

More information

University of Texas at Dallas Policy for Accepting Credit Card and Electronic Payments

University of Texas at Dallas Policy for Accepting Credit Card and Electronic Payments University f Texas at Dallas Plicy fr Accepting Credit Card and Electrnic Payments Cntents: Purpse Applicability Plicy Statement Respnsibilities f a Merchant Department Prcess t Becme a Merchant Department

More information

Hillsborough Board of Education Acceptable Use Policy for Using the Hillsborough Township Public Schools Network

Hillsborough Board of Education Acceptable Use Policy for Using the Hillsborough Township Public Schools Network 2361/Page 1 f 6 Hillsbrugh Bard f Educatin Acceptable Use Plicy fr Using the Hillsbrugh Twnship Public Schls Netwrk It is the gal f the HTPS (Hillsbrugh Twnship Public Schls) Netwrk t prmte educatinal

More information

Investment Adviser Switch Workshop

Investment Adviser Switch Workshop Investment Adviser Switch Wrkshp Investment Adviser Registratin, Renewal, Amendment And Pst-Registratin Requirements Presented by Office f the Attrney General Maryland Divisin f Securities 1 Registratin

More information

WHAT YOU NEED TO KNOW ABOUT. Protecting your Privacy

WHAT YOU NEED TO KNOW ABOUT. Protecting your Privacy WHAT YOU NEED TO KNOW ABOUT Prtecting yur Privacy YOUR PRIVACY IS OUR PRIORITY Credit unins have a histry f respecting the privacy f ur members and custmers. Yur Bard f Directrs has adpted the Credit Unin

More information

COLLATERAL VERIFICATION REVIEWS FREQUENTLY ASKED QUESTIONS

COLLATERAL VERIFICATION REVIEWS FREQUENTLY ASKED QUESTIONS NEW OR UPDATED ITEMS FOR 2016 Pwers f Attrney (Flrida & Gergia) The Bank is annuncing a new cllateral eligibility requirement fr lans clsed under pwer f attrney and secured by real estate lcated in the

More information

Bond Authorization Requested

Bond Authorization Requested District r Charter Schl Cntact Persn: Address 1: Address 2: City: Zip Cde: Telephne: Email Address: Bnd Authrizatin Requested The maximum bnd authrizatin that may be requested per district r charter schl

More information

Personal Data Security Breach Management Policy

Personal Data Security Breach Management Policy Persnal Data Security Breach Management Plicy 1.0 Purpse The Data Prtectin Acts 1988 and 2003 impse bligatins n data cntrllers in Western Care Assciatin t prcess persnal data entrusted t them in a manner

More information

Wire Transfer Request

Wire Transfer Request Wire Transfer Request Requirements and Instructins OFFICE OF DISBURSEMENTS Categry: Dcument Name: Payment Prcessing Wire Transfer Request - Requirements and Instructins Respnsible Department: Office f

More information

ES PROCEDURES FOR OVERPAYMENT RECOVERY

ES PROCEDURES FOR OVERPAYMENT RECOVERY ES PROCEDURES FOR OVERPAYMENT RECOVERY Effective: 7/1/2012 Respnsible Office: Emplyee Services (ES) Apprved: ES Directr Applicatin: All Emplyees f the University f Clrad Plicy The University f Clrad will

More information

Accessible Service Policy

Accessible Service Policy Accessible Service Plicy Date Created Revisin Oct. 16, 2012 1 Gal This plicy is intended t meet the requirements f the Accessibility Standards fr Custmer Service, Ontari Regulatin 429/07 under the Accessibility

More information

TITLE: Supplier Contracting Guidelines Process: FIN_PS_PSG_050 Replaces: Manual Sections 6.4, 7.1, 7.5, 7.6, 7.11 Effective Date: 10/1/2014 Contents

TITLE: Supplier Contracting Guidelines Process: FIN_PS_PSG_050 Replaces: Manual Sections 6.4, 7.1, 7.5, 7.6, 7.11 Effective Date: 10/1/2014 Contents TITLE: Supplier Cntracting Guidelines Prcess: FIN_PS_PSG_050 Replaces: Manual Sectins 6.4, 7.1, 7.5, 7.6, 7.11 Cntents 1 Abut university supplier cntracting... 2 2 When is a cntract required?... 2 3 Wh

More information

DIVISION OF INFORMATION TECHNOLOGY

DIVISION OF INFORMATION TECHNOLOGY DIVISION OF INFORMATION TECHNOLOGY Cellphne/Tablet Repairs Overview Flrida Internatinal University s Divisin f Infrmatin Technlgy is seeking submissins frm prpsed Licensees wh are interested in perating

More information

The information contained in this site is for INFORMATIONAL purposes only and is protected by copyright. We are not providing legal advice.

The information contained in this site is for INFORMATIONAL purposes only and is protected by copyright. We are not providing legal advice. Privacy Plicy Terms f Service: The fllwing terms and cnditins gvern all use f the Rightwaywebhsting.cm website and all cntent, services and prducts available at r thrugh the website (taken tgether, the

More information

Request for Proposal. Saskatchewan Arts Board. Database Development. RFP Reference Number S AB-ADMIN001. Release Date Februar y 9, 2016

Request for Proposal. Saskatchewan Arts Board. Database Development. RFP Reference Number S AB-ADMIN001. Release Date Februar y 9, 2016 Request fr Prpsal Saskatchewan Arts Bard Database Develpment RFP Reference Number S AB-ADMIN001 Release Date Februar y 9, 2016 Clsing Date March 1, 2016 Clsing Time 2:00 pm, Lcal Sask. Time Page 2 f 7

More information

FAFSA / DREAM ACT COMPLETION PROGRAM AGREEMENT

FAFSA / DREAM ACT COMPLETION PROGRAM AGREEMENT FAFSA / DREAM ACT COMPLETION PROGRAM AGREEMENT If using US Pstal Service, please return t: Califrnia Student Aid Cmmissin Prgram Administratin & Services Divisin ATTN: Institutinal Supprt P.O. Bx 419028

More information

CMS Eligibility Requirements Checklist for MSSP ACO Participation

CMS Eligibility Requirements Checklist for MSSP ACO Participation ATTACHMENT 1 CMS Eligibility Requirements Checklist fr MSSP ACO Participatin 1. General Eligibility Requirements ACO participants wrk tgether t manage and crdinate care fr Medicare fee-fr-service beneficiaries.

More information

CHARTER OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF UPLAND SOFTWARE, INC.

CHARTER OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF UPLAND SOFTWARE, INC. CHARTER OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF UPLAND SOFTWARE, INC. PURPOSE The purpse f the Cmpensatin Cmmittee f the Bard f Directrs (the Bard ) f Upland Sftware, Inc. (the Cmpany

More information

Municipal Advisor Registration

Municipal Advisor Registration FACT SHEET Municipal Advisr Registratin SEC Open Meeting Sept. 18, 2013 The Securities and Exchange Cmmissin tday will cnsider whether t adpt a rule that wuld establish a permanent registratin regime fr

More information

FORM ADV (Paper Version) UNIFORM APPLICATION FOR INVESTMENT ADVISER REGISTRATION AND REPORT FORM BY EXEMPT REPORTING ADVISERS

FORM ADV (Paper Version) UNIFORM APPLICATION FOR INVESTMENT ADVISER REGISTRATION AND REPORT FORM BY EXEMPT REPORTING ADVISERS APPENDIX A FORM ADV (Paper Versin) UNIFORM APPLICATION FOR INVESTMENT ADVISER REGISTRATION AND REPORT FORM BY EXEMPT REPORTING ADVISERS Frm ADV: General Instructins Read these instructins carefully befre

More information

Texas Woman's University University Policy Manual

Texas Woman's University University Policy Manual Texas Wman's University University Plicy Manual Plicy Name: Plicy Number: 6.06 Date Passed: July 2004 Health Insurance Prtability& Accuntability Act (HIPAA) Date Reviewed: September 2008 Next Review: September

More information

UNIVERSITY OF WINCHESTER

UNIVERSITY OF WINCHESTER UNIVERSITY OF WINCHESTER INTRODUCTION DEBT MANAGEMENT POLICY: STUDENTS ACADEMIC YEAR 15/16 This dcument sets ut the plicy f the University in relatin t student debt, alng with the debt management prcedures

More information

Checklist for Columbia State Community College s Course Creation Process

Checklist for Columbia State Community College s Course Creation Process Checklist fr Clumbia State Cmmunity Cllege s Curse Creatin Prcess Curses cannt be added t the schedule until this prcess is cmpleted, all curse dcuments are submitted, and the curse is apprved by the Directr

More information

CFD AND SPOT FOREX TERMS: DEPOSIT ACCOUNTS

CFD AND SPOT FOREX TERMS: DEPOSIT ACCOUNTS 1. Structure 1.1 When we engage in cfd r spt frex trading with yu, we d s n the basis f: - ur General Terms; these terms, i.e. ur CFD and Spt Frex Terms. 1.2 The CFD and Spt Frex Terms deal with matters

More information

Request for Proposal (RFP) RFP HQ2015-01 Training Session and Leadership Program Development Consulting Services

Request for Proposal (RFP) RFP HQ2015-01 Training Session and Leadership Program Development Consulting Services technserve.rg Date: January 5, 2014 Request fr Prpsal (RFP) RFP HQ2015-01 Training Sessin and Leadership Prgram Develpment Cnsulting Services Subject: Request fr Prpsal TechnServe Inc. (TNS) invites yu

More information

Key Steps for Organizations in Responding to Privacy Breaches

Key Steps for Organizations in Responding to Privacy Breaches Key Steps fr Organizatins in Respnding t Privacy Breaches Purpse The purpse f this dcument is t prvide guidance t private sectr rganizatins, bth small and large, when a privacy breach ccurs. Organizatins

More information

Systems Support - Extended

Systems Support - Extended 1 General Overview This is a Service Level Agreement ( SLA ) between and the Enterprise Windws Services t dcument: The technlgy services the Enterprise Windws Services prvides t the custmer. The targets

More information

Affiliate Service Agreement

Affiliate Service Agreement Affiliate Service Agreement A. Harringtn Limusine Service (HLS) is searching fr an Affiliate Partner in yur area t better serve HLS s clients. Please cmplete this fillable PDF frm in its entirety. In rder

More information

Service Request Form

Service Request Form New Prfessinal Services Order Frm Editable PDF Service Request Frm If yu have any questins while filling ut this frm, please cntact yur CDM, email Prfessinal Services at PS@swipeclck.cm, r call 888-223-3250

More information

NYU Langone Medical Center NYU Hospitals Center NYU School of Medicine

NYU Langone Medical Center NYU Hospitals Center NYU School of Medicine Title: Identity Theft Prgram Effective Date: July 2009 NYU Langne Medical Center NYU Hspitals Center NYU Schl f Medicine POLICY It is the plicy f the NYU Langne Medical Center t educate and train staff

More information

Directives to Hospitals in respect of Reporting Requirements under the BPSAA

Directives to Hospitals in respect of Reporting Requirements under the BPSAA DRAFT Directives t Hspitals in respect f Reprting Requirements under the BPSAA Issued By Minister f Health and Lng-Term Care Effective April 1, 2011 DRAFT March 28, 2011 Table f Cntents 1. BACKGROUND...

More information

--------------------------------------------------------------------------------------------------------------------------------------------

-------------------------------------------------------------------------------------------------------------------------------------------- --------- REQUEST FOR QUOTE VOICE OVER INTERNET PROTOCOL PHONE SYSTEM UPGRADE Revisin 1 Issue date: December 16, 2014 Deadline Date: January 16, 2015 Cntact persn: Chris Hgan, Directr f Prtective Services

More information

CONSTRUCTION INDUSTRIES & MANUFACTURED HOUSING DIVISION

CONSTRUCTION INDUSTRIES & MANUFACTURED HOUSING DIVISION New Mexic Regulatin and Licensing Department 2550 Cerrills Rad Santa Fe, NM 87505 Ph (505) 476-4700 Fax (505) 476-4685 INSTRUCTIONS FOR FILING A COMPLAINT Thank yu fr cntacting The New Mexic Regulatin

More information

Audit Committee Charter

Audit Committee Charter Audit Cmmittee Charter Membership The Audit Cmmittee (the "Cmmittee") f the Bard f Directrs (the "Bard") f Philip Mrris Internatinal Inc. (the "Cmpany") shall cnsist f at least three directrs all f whm

More information

First Global Data Corp.

First Global Data Corp. First Glbal Data Crp. Privacy Plicy As f February 23, 2015 Ding business with First Glbal Data Crp. ("First Glbal", First Glbal Mney, "we" r "us", which includes First Glbal Data Crp. s subsidiary, First

More information

Workers Compensation Employee Packet

Workers Compensation Employee Packet Wrkers Cmpensatin Emplyee Packet Cmplete the fllwing frms and return t Meagan Vrhies, Claims Crdinatr via fax (817) 735-0127, email at Meagan.Vrhies@untsystem.edu r in persn at Human Resurce Services (EAD-280).

More information

FIREFIGHTER HEART AND CIRCULATORY MALFUNCTION BENEFITS PROGRAM STANDARD OPERATING GUIDELINES Approved by the DOLA Executive Director July 1, 2014

FIREFIGHTER HEART AND CIRCULATORY MALFUNCTION BENEFITS PROGRAM STANDARD OPERATING GUIDELINES Approved by the DOLA Executive Director July 1, 2014 FIREFIGHTER HEART AND CIRCULATORY MALFUNCTION BENEFITS PROGRAM STANDARD OPERATING GUIDELINES Apprved by the DOLA Executive Directr July 1, 2014 Prgram Overview: As f July 1, 2014, the Department f Lcal

More information

VCU Payment Card Policy

VCU Payment Card Policy VCU Payment Card Plicy Plicy Type: Administrative Respnsible Office: Treasury Services Initial Plicy Apprved: 12/05/2013 Current Revisin Apprved: 12/05/2013 Plicy Statement and Purpse The purpse f this

More information

BLUE RIDGE COMMUNITY AND TECHNICAL COLLEGE BOARD OF GOVERNORS

BLUE RIDGE COMMUNITY AND TECHNICAL COLLEGE BOARD OF GOVERNORS BLUE RIDGE COMMUNITY AND TECHNICAL COLLEGE BOARD OF GOVERNORS SERIES: 1 General Rules RULE: 17.1 Recrd Retentin Scpe: The purpse f this rule is t establish the systematic review, retentin and destructin

More information

CLIENT AGREEMENT School Based Trainees

CLIENT AGREEMENT School Based Trainees Smart Emplyment Slutins Ltd t/as Hassle Free Apprentice Management Versin: 04 Date: 01/15 Smart Emplyment Slutins trading as Hassle Free Apprentice Management (ACN 067 508 338) (ABN 68 067 508 338) Email:

More information

Sonny s Franchise Company 201 North New York Avenue 3rd floor Winter Park, FL 32789

Sonny s Franchise Company 201 North New York Avenue 3rd floor Winter Park, FL 32789 Snny s Franchise Cmpany 201 Nrth New Yrk Avenue 3rd flr Winter Park, FL 32789 Phne: (407) 660-8888 Fax: (407) 660-1285 Email: sates@snnysbbq.cm Name Address PRELIMINARY FRANCHISE APPLICATION Befre filling

More information

IMPORTANT INFORMATION ABOUT MEDICAL CARE FOR YOUR WORK-RELATED INJURY OR ILLNESS

IMPORTANT INFORMATION ABOUT MEDICAL CARE FOR YOUR WORK-RELATED INJURY OR ILLNESS IMPORTANT INFORMATION ABOUT MEDICAL CARE FOR YOUR WORK-RELATED INJURY OR ILLNESS MEDICAL PROVIDER NETWORK (MPN) NOTIFICATION If yu are injured at wrk, Califrnia Law requires yur emplyer t prvide and pay

More information

Nebraska Parenting Act Divorce and Separation Parenting Education Provider Information 2015 Application

Nebraska Parenting Act Divorce and Separation Parenting Education Provider Information 2015 Application Nebraska Parenting Act Divrce and Separatin Parenting Educatin Prvider Infrmatin 2015 Applicatin A. Apprval Prcess: Please submit the fllwing in the rder listed: 1. Prvider infrmatin sheet: Please cmplete

More information

Online Banking Agreement

Online Banking Agreement Online Banking Agreement 1. General This Online Banking Agreement, which may be amended frm time t time by us (this "Agreement"), fr accessing yur Clrad Federal Savings Bank accunt(s) via the Internet

More information

TRAINING PLAN FOR STEM OPT STUDENTS

TRAINING PLAN FOR STEM OPT STUDENTS Adapted by UW Madisn (and inspired by the University f Michigan) frm the fllwing surce: https://www.ice.gv/sites/default/files/dcuments/dcument/2016/i983instructins.pdf Cmpleting the Frm I 983 TRAINING

More information

How To Contact Skrill

How To Contact Skrill Skrill Merchant Services Applicatin Frm Skrill Merchant Services Applicatin Frm (the Applicatin ) shuld be signed by r n behalf f the Merchant. It is very imprtant that the Merchant has read the Applicatin

More information

Cyber Security: Simulation Platform

Cyber Security: Simulation Platform Service Overview The Symantec Cyber Security: Simulatin Platfrm is a Web hsted Service with immersive and hands-n access t cyber exercises fr ffensive (red team) events, inspired by real-life security

More information

Internet Banking Agreement and Disclosure Statement

Internet Banking Agreement and Disclosure Statement Internet Banking Agreement and Disclsure Statement This agreement cntains the terms and cnditins that gvern accessing r using Internet Banking (NetTeller), Bill Payment Services, Mbile Banking and On Demand

More information

COUNTY OF SACRAMENTO PLANNING AND ENVIRONMENTAL REVIEW

COUNTY OF SACRAMENTO PLANNING AND ENVIRONMENTAL REVIEW COUNTY OF SACRAMENTO PLANNING AND ENVIRONMENTAL REVIEW REQUEST FOR PROPOSAL fr ON-CALL CULTURAL RESOURCE SERVICES Release Date: Tuesday, March 10, 2015 Submittal Deadline: Mnday, April 13, 2015 by 5:00

More information

Project Open Hand Atlanta. Health Insurance Portability and Accountability Act (HIPAA) NOTICE OF PRIVACY PRACTICES

Project Open Hand Atlanta. Health Insurance Portability and Accountability Act (HIPAA) NOTICE OF PRIVACY PRACTICES Prject Open Hand Atlanta Effective Date: April 14, 2003 Health Insurance Prtability and Accuntability Act (HIPAA) The Health Insurance Prtability and Accuntability Act f 1996 (HIPAA) directs health care

More information

GOVERNORS PHARMACY HIPAA NOTICE OF PRIVACY PRACTICES For Your Protected Health Information

GOVERNORS PHARMACY HIPAA NOTICE OF PRIVACY PRACTICES For Your Protected Health Information GOVERNORS PHARMACY HIPAA NOTICE OF PRIVACY PRACTICES Fr Yur Prtected Health Infrmatin THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS

More information

Information Security Policy

Information Security Policy Purpse The risk t Charlestn Suthern University, its emplyees and students frm data lss and identity theft is f significant cncern t the University and can be reduced nly thrugh the cmbined effrts f every

More information

DisplayNote Technologies Limited Data Protection Policy July 2014

DisplayNote Technologies Limited Data Protection Policy July 2014 DisplayNte Technlgies Limited Data Prtectin Plicy July 2014 1. Intrductin This dcument sets ut the bligatins f DisplayNte Technlgies Limited ( the Cmpany ) with regard t data prtectin and the rights f

More information

Cell Phone & Data Access Policy Frequently Asked Questions

Cell Phone & Data Access Policy Frequently Asked Questions Cell Phne & Data Access Plicy Frequently Asked Questins 1. Wh is eligible fr a technlgy allwance? First and fremst, the technlgy allwance is fr the benefit f the University, rather than fr the cnvenience

More information

The Jackson Laboratory Third-Party Fundraising Guidelines

The Jackson Laboratory Third-Party Fundraising Guidelines The Jacksn Labratry Third-Party Fundraising Guidelines DEFINITION A Third-Party Fundraiser ( Fundraiser ) is defined as an rganizatin, crpratin, grup r individual raising mney fr The Jacksn Labratry (the

More information

How To Get A Credit By Examination

How To Get A Credit By Examination LAW ENFORCEMENT TECHNOLOGY CREDIT BY EXAMINATION FACT SHEET Texas Ri Salad Cllege, a Maricpa Cunty Cmmunity Cllege in Tempe, Arizna, is prud t annunce its Credit by Examinatin prgram in Law Enfrcement

More information

SEO/SEM AGREEMENT. 4. CUSTOMER RESPONSIBILITIES. For the purposes of providing these services, Customer agrees:

SEO/SEM AGREEMENT. 4. CUSTOMER RESPONSIBILITIES. For the purposes of providing these services, Customer agrees: SEO/SEM AGREEMENT THIS AGREEMENT ("Agreement") is made and entered int this day f, (the "Effective Date") by and between Ishbel M. Lane ("Cnsultant") and ("Custmer"). WHEREAS, the Custmer wishes t engage

More information

BridgeValley Community and Technical College Financial Aid Office 2015-2016 Maximum Hour Financial Aid Suspension Appeal Process

BridgeValley Community and Technical College Financial Aid Office 2015-2016 Maximum Hour Financial Aid Suspension Appeal Process BridgeValley Cmmunity and Technical Cllege Financial Aid Office 2015-2016 Maximum Hur Financial Aid Suspensin Appeal Prcess T receive financial aid administered by BridgeValley Cmmunity and Technical Cllege,

More information

Transportation Allowance Program

Transportation Allowance Program Transprtatin Allwance Prgram Respnsibilities, Prcedures and Guidelines I. INTRODUCTION This manual describes respnsibilities, prcedures and guidelines (including vehicle specificatins and reimbursable

More information

Convenience Fees BEST PRACTICES FOR MERCHANT USE OF CONVENIENCE FEES:

Convenience Fees BEST PRACTICES FOR MERCHANT USE OF CONVENIENCE FEES: Cnvenience Fees This publicatin includes Card Acceptance Guide language n Best Practices fr Merchant Use f Cnvenience Fees in additin t addressing specific differences by card brand and special circumstances

More information

Malpractice and Maladministration Policy

Malpractice and Maladministration Policy TR340 Malpractice and Maladministratin Plicy This plicy aims t: Define malpractice and maladministratin in the cntext f CIM/CAM studying members, Accredited study centres (ASCs), examinatin centres, invigilatrs

More information

Agency Fund (Non-Student Org X-Fund) Guidelines Last Revision: 12/7/2009

Agency Fund (Non-Student Org X-Fund) Guidelines Last Revision: 12/7/2009 Agency Fund (Nn-Student Org X-Fund) Guidelines Last Revisin: 12/7/2009 Definitin f Agency Fund: An Agency Fund cnsists f funds held by Eastern Michigan University as custdian r fiscal agent fr thers, such

More information

Privacy Breach and Complaint Protocol

Privacy Breach and Complaint Protocol Privacy Breach and Cmplaint Prtcl Effective: December 31, 2012 Apprved by: Le McKenna, CFO 1.0 General Privacy breaches and privacy cmplaints will be handled in accrdance with this prtcl. This prtcl is

More information

Privacy Policy. The Central Equity Group understands how highly people value the protection of their privacy.

Privacy Policy. The Central Equity Group understands how highly people value the protection of their privacy. Privacy Plicy The Central Equity Grup understands hw highly peple value the prtectin f their privacy. Fr that reasn, the Central Equity Grup takes particular care in dealing with any persnal and sensitive

More information

Spread Bet Terms: Deposit Accounts

Spread Bet Terms: Deposit Accounts Spread Bet Terms: Depsit Accunts 1. Structure 1.1 When we engage in Spread Betting with yu, we d s n the basis f: - ur General Terms; these terms, i.e. ur Spread Terms. 1.2 The Spread Terms deal with matters

More information