HomeMy WebLinkAboutExhibit 14City of Miami, Florida Health Benefit Consulting Services and Actuarial Services RFQ 05-06-005
6.1. RFQ Information Form
Issue Date: March 13, 2006
RFQ No.: 05-06-005
Buyer: Glenn Marcos, CPPO, CPPB
Email: gmarcosaci.rniami.fl.us
Commodity'Codes; ..:... ..
918-58; 953-60; 961-49; 961-51; 964-63
TERM CONTRACT
HEALTH BENEFIT CONSULTING SERVICES
AND
ACTUARIAL SERVICES
RFQ NO. 05-06-005
SELECT ONE OR MORE AREAS OF EXPERTISE BEING SOUGHT FOR 0 UALIFICATION:
O Category A. Health Benefit Consulting
Services
❑ Category B Health Actuaries 0 Category D Pension Actuaries
❑ Category C Life Actuaries 0 Category E Casualt V apse;
I certify that any and all information contained in this Proposal is true; and I further certify that this Proposal
is made without prior understanding, agreement, or connections with any corporation, firm or person
submitting a Proposal for the same materials, supplies, equipment, or services and is in all respects fair and
without collusion or fraud. 1 agree to abide by all terms and conditions of the RFQ, and certify that I am
authorized to sign for the Proposer. Please print the following and sign your name.
Firm's Name: Telephone:
Principal Business Address: Fax:
E-mail address:
Name:
Title:
Mailing Address:
Authorized Signature:
28