HomeMy WebLinkAboutRequest for ProposalsCity of Miami
Request for Proposals
(RFP)
Purchasing Department
Miami Riverside Center
444 SW 2nd Avenue, 6th Floor
Miami, Florida 33130
Web Site Address: http://ci.miami.fl.us/procurement
RFP Number:
Title:
Issue Date/Time:
RFP Closing Date/Time:
Pre -Bid Conference:
Pre -Bid Date/Time:
Pre -Bid Location:
Deadline for Request for Clarification:
Buyer:
Hard Copy Submittal Location:
Buyer E-Mail Address:
Buyer F:;csimile:
207193,2
Request for Proposals for Claims
Administration Services & Managed
Care Services
13-APR-2010
05/17/2010 @ 12:00:00
Mandatory
Monday, April 19, 2010 at 10:00 a.m.
444 SW 2nd Avenue, loth Floor Large
Conference Room, Miami, Florida
Tuesday, April 20, 2010 at 3:00 PM
Eastern Standard Time
Suarez, Maritza
City of Miami - City Clerk
3500 Pan American Drive
Miami FL 33133 US
msuarez@ci.miami.fl.0 s
(305) 400-5025
Page 1 of 58
Certification Statement
Please quote on this form, if applicable, net prices for the item(s) listed. Return signed original and
retain a copy for your files. Prices should include all costs, including transportation to destination. The
City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a
minimum of 120 days following the time set for closing of the submissions.
hi the event of errors in extension of totals, the unit prices shall govern in determining the quoted
prices.
We (I) certify that we have read your solicitation, completed the necessary documents, and propose to
furnish and deliver, F.O.B. DESTINATION, the items or services specified herein.
The undersigned hereby certifies that neither the contractual party nor any of its principal owners or
personnel have been convicted of any of the violations, or debarred or suspended as set in section
18-107 or Ordinance No. 12271.
All exceptions to this submission have been documented in the section below (refer to paragraph and
section).
EXCEPTIONS:
We (1) certify that any and all information contained in this submission is true; and we (I) further certify
that this submission is made without prior understanding, agreement, or connection with any
corporation, firm, or person submitting a submission for the same materials, supplies, equipment, or
service, and is in all respects fair and without collusion or fraud. We (I) agree to abide by all terms and
conditions of this solicitation and certify that 1 am authorized to sign this submission for the submitter.
Please print the following and sign your name:
SUPPLIER NAME •
ADDRESS •
PHONE: FAX
EMAIL: BEEP} •
SIGNED BY•
TITLE: DATE.
FAILURE TO COMPLETE. SIGN. AND RETURN THIS FORM SHALL DISQUALIFY THIS BID.
Page 2 of 58
Certifications
Legal Name of Firm:
Entity Type: Partnership, Sole Proprietorship, Corporation, etc.
Year Established:
Business Address:
City, State, and Zip Code:
Telephone Number:
Fax Number:
E-mail Address:
Office Location: City of Miami, Miami -Dade County, or Other
Occupational License Number:
Occupational License Issuing Agency:
Occupational License Expiration Date:
Respondent certifies that (s) he has read and understood the provisions of City of Miami Ordinance No.
10032 (Section 18-105 of the City Code) pertaining to the implementation of a "First Source Hiring
Agreement.": (Yes or No)
Page 3 of 58
Do you expect to create new positions in your company in the event your company was awarded a
Contract by the City? (Yes or No)
In the event your answer to question above is yes, how many new positions would you create to
perform this work?
Please list the title, rate of pay, summary of duties, number of positions, and expected length or duration
of all new positions which might be created as a result of this award of a Contract.
Will Subcontractor(s) be used? (Yes or No)
Page4of58
Line: 1
Description: Total Annual Fee to Provide Part I Services - Workers Compensation Claims
Administration, as per the Scope of Work
Proposer shall clearly indicate in proposal if providing a response for Part I, Part I1, and/or Part
1II Services.
Category: 95327-00
Unit of Measure: Year
Unit Price: $
Line: 2
Number of Units: 3 Total: $
Description: Total Annual Fee to Provide Part II Services - General, Automobile, and Professional
Liability Claims Administration, as per the Scope of Work
Category: 95327-00
Unit of Measure: Year
Unit Price: $
Line: 3
Number of Units: 3 Total: $
Description: Total Annual Fee to Provide Part III Services - Statutory Managed Care Services, as
per the Scope of Work
Category: 95327-00
Unit of Measure: Year
Unit Price: $
Line: 4
Number of Units: 3 Total: $
Description: Total Annual Fee to Provide Part HI Services - Non -Statutory Managed Care
Services, as per the Scope of Work
Category: 95327-00
Unit of Measure: Year
Unit Price: $
Number of Units: 3 Total: $
Page 5 of 58
Line: 5
Description: Per Claim Fee to Provide Part I Services - Workers Compensation Claims
Administration. (Estimated quantities provided are on an annual basis)
Line: 5.1
Description: Existing. Claims for lost time
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 5.2
Number of Units: 1,039 Total: $
Description: Existing Claims for medical only
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 5.3
Number of Units: 29 Total: $
Description: Prospective Claims for lost time
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 5.4
Number of Units: 406 Total: $
Description: Prospective Claims for medical only
Category: 95327-00
Unit of Measure: Each
Page 6 of 58
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 6.5
Number of Units: 254 Total: $
Description: Prospective Claims for Automobile Liability
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 6.6
Number of Units: 358 Total: $
Description: Prospective Claims for Professional Liability
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 7
Number of Units: 27 Total: $
Description: Per Claim Fee to Provide Part III Services - Statutory Managed Care. (Estimated
quantities provided are on an annual basis)
Line: 7.1
Description: Existing Claims for lost time
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 7.2
Number of Units: 78 Total: $
Page 8 of 58
Description: Existing Claims for medical only
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 7.3
Number of Units: 615 Total: $
Description: Prospective Claims for lost time
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 7.4
Number of Units: 406 Total: $
Description: Prospective Claims for medical only
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Line: 8
Number of Units: 396 Total: $
Description: Per Claim Fee to Provide Part III Services - Non -Statutory Managed Care.
(Estimated quantities provided are on an annual basis)
Line: 8.1
Description: Existing Claims for lost time
Category: 95327-00
Unit of Measure: Each
Unit Price: $
Number of Units: 78 Total: $
Page 9 of 58
Request for Proposals (REP) 207193,2
Table of Contents
Terms and Conditions I2
1. General Conditions 12
1.1. GENERAL TERMS AND CONDITIONS 12
2. Special Conditions ?9
2.1. PURPOSE 29
2.2. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL
INFORMATION/CLARIFICATION 29
2.3. TERM OF CONTRACT 29
2.4. CONDITIONS FOR RENEWAL 29
2.5. NON -APPROPRIATION OF FUNDS 29
2.6. MINIMUM QUALIFICATION REQUIREMENTS 29
2.7. CONTRACT EXECUTION 30
2.8. MANDATORY PRE -PROPOSAL CONFERENCE 30
2.9. FAILURE TO PERFORM 30
2.10. INSURANCE REQUIREMENTS 30
2.11. CONTRACT ADMINISTRATOR 32
2.12. SUBCONTRACTOR(S) OR SUBCONSULTANT(S) 32
2.13. TERMINATION 32
2.14. ADDITIONAL TERMS AND CONDITIONS 33
2.15. PRIMARY CLIENT (FIRST PRIORITY) 33
2.16. UNAUTHORIZED WORK 33
2.17. CHANGES/ALTERATIONS 33
2.18. COMPENSATION PROPOSAL 33
2.19. EVALUATION/SELECTION PROCESS AND CONTRACT AWARD 33
2.20. ADDITIONAL SERVICES 34
2.21. RECORDS 34
2.22. ATTACHMENTS 34
2.23. TRUTH IN NEGOTIATION CERTIFICATE 35
3. Specifications 36
3.1. SPECIFICATIONS/SCOPE OF WORK 36
4. Submission Requirements 51
4.1. SUBMISSION REQUIREMENTS 51
5. Evaluation Criteria 58
5.1. EVALUATION CRITERIA 58
Page 11 of 58
Request for Proposals (RFP) 207193.2
Terms and Conditions
1. General Conditions
1.1. GENERAL TERMS AND CONDITIONS
Intent: The General Terms and Conditions described herein apply to the acquisition of
goods/equipment/services with an estimated aggregate cost of $25,000.00 or more.
Definition: A formal solicitation is defined as issuance of an Invitation for Bids, Request for Proposals,
Request for Qualifications, or Request for Letters of Interest pursuant to the City of
Miami Procurement Code and/or Florida Law, as amended. Formal Solicitation and Solicitation shall be
defined in the same manner herein.
1.1. ACCEPTANCE OF GOODS OR EQUIPMENT - Any good(s).or equipment delivered under this
formal solicitation, if applicable, shall remain the property of the seller until a physical inspection and
actual usage of the good is made, and thereafter is accepted as satisfactory to the City. It must comply with
the terms herein and be fully in accordance with specifications and of the highest quality. In the event the
goods/equipment supplied to the City are found to be defective or does not conform to specifications, the
City reserves the right to cancel the order upon written notice to the Contractor and return the product to the
Contractor at the Contractor's expense.
1.2. ACCEPTANCE OF OFFER - The signed or electronic submission of your solicitation response shall
be considered an offer on the part of the bidder/proposer; such offer shall be deemed accepted upon
issuance by the City of a purchase order.
1.3. ACCEPTANCE/REJECTION — The City reserves the right to accept or reject any or all responses or
parts of after opening/closing date and request re -issuance on the goods/services described in the formal
solicitation. In the event of such rejection, the Director of Purchasing shall notify all affected
bidders/proposers and make available a written explanation for the rejection. The City also reserves the
right to reject the response of any bidder/proposer who has previously failed to properly perform under the
terms and conditions of a contract, to deliver on time contracts of a similar nature, and who is not in a
position to perform the requirements defined in this formal solicitation. The City further reserves the right
to waive any irregularities or minor informalities or technicalities in any or all responses and may, at its
discretion, re -issue this formal solicitation.
1.4. ADDENDA — It is the bidder's/proposer's responsibility to ensure receipt of all Addenda. Addenda are
available at the City's website at: http://www.ci.miami.fl.us/procurement
1.5. ALTERNATE RESPONSES MAY BE CONSIDERED - The City may consider one (1) altemate
response from the same Bidder/Proposer for the same formal solicitation; provided, that the alternate
response offers a different product that meets or exceeds the formal solicitation requirements. In order for
the City to consider an alternate response, the Bidder/Proposer shall complete a separate Price Sheet form
and s'_7'1I mark "Alternate Response". Alternate response shall be placed in die same response. This
provision only applies to formal solicitations for the procurement of goods, services, items, equipment,
materials, and/or supplies.
1.6. ASSIGNMENT - Contractor agrees not to subcontract, assign, transfer, convey, sublet, or otherwise
dispose of the resulting Contract, or any or all of its right, title or interest herein, without City of Miami's
prior written consent.
1.7. ATTORNEY'S FEES - In connection with any litigation, mediation and arbitration arising out of this
Contract, the prevailing party shall be entitleu to recover its costs and reasonable attorney's fees through
and including appellate litigation and any post judgment proceedings.
1.8. AUDIT RIGHTS AND RECORDS RETENTION - The Successful Bidder/Proposer agrees to
provide access at all reasonable times to the City, or to any of its duly authorized representatives, to any
books, documents, papers, and records of Contractor which are directly pertinent to this formal solicitation,
for the purpose of audit, examination, excerpts, and transcriptions. The Successful Bidder/Proposer shall
maintain and retain any and all of the books, documents, papers and records pertinent to the Contract for
Page 12 of 58
Request for Proposals (RFP) 207193,2
three (3) years after the City makes final payment and all other pending matters are closed. Contractor's
failure to or refusal to comply with this condition shall result in the immediate cancellation of this contract
by the City.
1.9. AVAILABILITY OF CONTRACT STATE-WIDE - Any Governmental, not -for -profit or
quasi -governmental entity in the State of Florida, may avail itself of this contract and purchase any and all
goods/services, specified herein from the successful bidder(s)/proposer(s) at the contract price(s)
established herein, when permissible by federal, state, and local laws, rules, and regulations.
Each Governmental, not -for -profit or quasi -governmental entity which uses this formal solicitation and
resulting bid contract or agreement will establish its own contract/agreement, place its own orders, issue its
own purchase orders, be invoiced there from and make its own payments, determine shipping terms and
issue its own exemption certificates as required by the successful bidder(s)/proposer(s).
1.10. AWARD OF CONTRACT:
A. The Formal Solicitation, Bidder's/Proposer's response, any addenda issued, and the purchase order shall
constitute the entire contract, unless modified in accordance with any ensuing contract/agreement,
amendment or addenda.
B. The award of a contract where there are Tie Bids will be decided by the Director of Purchasing or
designee in the instance that Tie Bids can't be determined by applying Florida Statute 287.087, Preference
to Businesses with Drug -Free Workplace Programs.
C. The award of this contract may be preconditioned on the subsequent submission of other documents as
specified in the Special Conditions or Technical Specifications. Bidder/Proposer shall be in default of its
contractual obligation if such documents are not submitted in a timely manner and in the form required by
the City. Where Bidder/Proposer is in default of these contractual requirements, the City, through action
taken by the Purchasing Department, will void its acceptance of the Bidder's/Proposer's Response and may
accept the Response from the next lowest responsive, responsible Bidder or Proposal most advantageous to
the City or re -solicit the City's requirements. The City, at its sole discretion, may seek monetary restitution
from Bidder/Proposer and its bid/proposal bond or guaranty, if applicable, as a result of damages or
increased costs sustained as a result of the Bidder's/Proposer's default.
D. The term of the contract shall be specified in one of three documents which shall be issued to the
successful Bidder/Proposer. These documents may either be a purchase order, notice of award and/or
contract award sheet.
E. The City reserves the right to automatically extend this contract for up to one hundred twenty (120)
calendar days beyond the stated contract term in order to provide City departments with continual service
and supplies while a new contract is being solicited, evaluated, and/or awarded. If the right is exercised,
the City shall notify the Bidder/Proposer, in writing, of its intent to extend the contract at the same price,
terms and conditions for a specific number of days. Additional extensions over the first one hundred
twenty (120) day extension may occur, if, the City and the Successful Bidder/Proposer are in mutual
agreement of such extensions.
F. Where the contract involves a single shipment of goods to the City, the contract term shall conclude
upon completion of the expressed or implied warranty periods.
G. The City reserves the int to award the contract on a split -order, lump sum or individual-itc:u-oasis,
or such combination as shall best serve the interests of the City unless otherwise specified.
H. A Contract/Agreement may be awarded to the Bidder/Proposer by the City Commission based upon
the minimum qualification requirements reflected herein. As a result of a RFP, RFQ, or RFLI, the City
reserves the right to execute or not execute, as applicable, an Agreement with the Proposer, whichever is
determined to be in the City's best interests. Such agreement will be furnished by the City, will contain
certain terms as are in the City's best interests, and will be subject to approval as to legal form by the City
Attorney.
1.11. BID BOND/ BID SECURITY - A cashier's or certified check, or a Bid Bond signed by a recognized
surety company that is licensed to do business in the State of Florida, payable to the City of Miami, for the
amount bid is required from all bidders/proposers, if so indicated under the Special Conditions. This check
or bond guarantees that a bidder/proposer will accept the order or contract/agreement, as bid/proposed, if it
is awarded to bidder/proposer. Bidder/Proposer shall forfeit bid deposit to the City should City award
Page 13 of 58
Request for Proposals (RFP) 207193,2
contract/agreement to Bidder/Proposer and Bidder/Proposer fails to accept the award. The City reserves the
right to reject any and all surety tendered to the City. Bid deposits are returned to unsuccessful
bidders/proposers within ten (10) days after the award and successful bidder's/proposer's acceptance of
award. If sixty (60) days have passed after the date of the formal solicitation closing date, and no contract
has been awarded, all bid deposits will be returned on demand.
1.12. RESPONSE FORM (HARDCOPY FORMAT) - All forms should be completed, signed and
submitted accordingly.
1.13. BID SECURITY FORFEITED LIQUIDATED DAMAGES - Failure to execute an Agreement
and/or file an acceptable Performance Bond, when required, as provided herein, shall be just cause for the
annulment of the award and the forfeiture of the Bid Security to the City, which forfeiture shall be
considered, not as a penalty, but in mitigation of damages sustained. Award may then be made to the
next lowest responsive, responsible Bidder or Proposal most advantageous to the City or all responses may
be rejected.
1.14. BRAND NAMES - If and wherever in the specifications brand names, makes, models, names of any
manufacturers, .trade names, or bidder/proposer catalog numbers are specified, it is for the purpose of
establishing the type, function, minimum standard of design, efficiency, grade or quality of goods only.
When the City does not wish to rule out other competitors' brands or makes, the phrase "OR EQUAL" is
added. When bidding/proposing an approved equal, Bidders/Proposers will submit, with their response,
complete sets of necessary data (factory information sheets, specifications, brochures, etc.) in order for the
City to evaluate and determine the equality of the item(s) bid/proposed. The City shall be the sole judge of
equality and its decision shall be final. Unless otherwise specified, evidence in the form of samples may be
requested if the proposed brand is other than specified by the City. Such samples are to be furnished after
formal solicitation opening/closing only upon request of the City. If samples should be requested, such
samples must be received by the City no later than seven (7) calendar days after a formal request is made.
1.15. CANCELLATION - The City reserves the right to cancel all formal solicitations before its
opening/closing. In the event of bid/proposal cancellation, the Director of Purchasing shall notify all
prospective bidders/proposers and make available a written explanation for the cancellation.
1.16. CAPITAL EXPENDITURES - Contractor understands that any capital expenditures that the firm
makes, or prepares to make, in order to deliver/perform the goods/services required by the City, is a
business risk which the contractor must assume. The City will not be obligated to reimburse amortized or
unamortized capital expenditures, or to maintain the approved status of any contractor. If contractor has
been unable to recoup its capital expenditures during the time it is rendering such goods/services, it shall
not have any claim upon the City.
1.17. CITY NOT LIABLE FOR DELAYS - It is further expressly agreed that in no event shall the City
be liable for, or responsible to, the Bidder/Proposer/Consultant, any sub-contractor/sub-consultant, or to
any other person for, or on account of, any stoppages or delay in the work herein provided for by injunction
or other legal or equitable proceedings or on account of any delay for any cause over which the City has no
control.
1.18. COLLUSION —Bidder/Proposer, by submitting a response, certifies that its response is made without
previous understanding, agreement or connection ether with any person, firm or corporation submitting a
response for the same items/services or with the:C , of Miami's Purchasing Department or initiating
department. The Bidder/Proposer certifies that its response is fair, without control, collusion, fraud or other
illegal action. Bidder/Proposer certifies that it is in compliance with the Conflict of Interest and Code of
Ethics Laws. The City will investigate all potential situations where collusion may have occurred and the
City reserves the right to reject any and all bids/responses where collusion may have occurred.
1.19. COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS - Contractor understands that
contracts between private entities and local governments are subject to certain laws and regulations,
including Saws pertaining to public records, conflict of interest, records keeping, etc. City and Contractor
agree to comply with and observe all applicable laws, codes and ordinances as that may in any way affect
the goods or equipment offered, including but not limited to:
A. Executive Order 11246, which prohibits discrimination against any employee, applicant, or client
because of race, creed, color, national origin, sex, or age with regard to, but not limited to, the following:
employment practices, rate of pay or other compensation methods, and training selection.
Page 14 of 58
Request for Proposals (RFP) 207193,2
B. Occupational, Safety and Health Act (OSHA), as applicable to this Formal Solicitation.
C. The State of Florida Statutes, Section 287.133(3)(A) on Public Entity Crimes.
D. Environment Protection Agency (EPA), as applicable to this Formal Solicitation.
E. Uniform Commercial Code (Florida Statutes, Chapter 672).
F. Americans with Disabilities Act of 1990, as amended.
G. National Institute of Occupational Safety Hazards (NIOSH), as applicable to this Formal Solicitation.
H. National Forest Products Association (NFPA), as applicable to this Formal Solicitation.
1. City Procurement Ordinance City Code Section 18, Article III.
J. Conflict of Interest, City Code Section 2-611;61.
K. Cone of Silence, City Code Section 18-74.
L. The Florida Statutes Sections 218.73.and.218.74 on Prompt Payment.
M. First Source Hiring Agreement, City Ordinance No. 10032, as applicable to this Formal Solicitation.
Implemented to foster the creation of new and permanent jobs for City of Miami residents; requires as a
condition precedent to the execution of service contracts including professional services.
Lack of knowledge by the bidder/proposer will in no way be a cause for relief from responsibility.
Non-compliance with all local, state, and federal directives, orders, and laws may be considered grounds
for termination of contract(s).
Copies of the City Ordinances may be obtained from the City Clerk's Office.
1.20. CONE OF SILENCE - Pursuant to Section 18-74 of the City of Miami Code, a "Cone of Silence" is
imposed upon each RFP, RFQ, RFLI, or IFB after advertisement and terminates at the time the City
Manager issues a written recommendation to the Miami City Commission. The Cone of Silence shall be
applicable only to Contracts for the provision of goods and services and public works or improvements for
amounts greater than $200,000. The Cone of Silence prohibits any communication regarding RFPs, RFQs,
RFLI or IFBs (bids) between, among others:
Potential vendors, service providers, bidders, lobbyists or consultants and the City's professional staff
including, but not limited to, the City Manager and the City Manager's staff; the Mayor, City
Commissioners, or their respective staffs and any member of the respective selection/evaluation committee.
The provision does not apply to, among other communications:
oral communications with the City purchasing staff, provided the communication is limited strictly to
matters of process or procedure already contained in the formal solicitation document; the provisions of the
Cone of Silence do not apply to oral communications at duly noticed site visits/inspections, pre -proposal or
pre -bid conferences, oral presentations before selection/evaluation committees, contract negotiations during
any duly noticed public meeting, or public presentations made to the Miami City Commission during a duly
noticed public meeting; or communications in writing or by email at any :time with any City employee,
r.`*, cial or member of the City Commission unless specifically prohibit' l liy the applicable RFP, RFQ,
RFLI or IFB (bid) documents (See Section 2.2. of the Special Conditions); or communications in
connection with the collection of industry comments or the performance of market research regarding a
particular RFP, RFQ, RFLI OR IFB by City Purchasing staff.
Proposers or bidders must file a copy of any written communications with the Office of the City Clerk,
which shall be made available to any person upon request. The City shall respond in writing and file a copy
with the Office of the City Clerk, which shall be made available to any person upon request. Written
communications may be in the form of ez.nail, with a copy to the Office of the City Clerk.
In addition to any other penalties provided by law, violation of the Cone of Silence by any proposer or
bidder shall render any award voidable. A violation by a particular Bidder, Proposer, Offeror, Respondent,
lobbyist or consultant shall subject same to potential penalties pursuant to the City Code. Any person
having personal knowledge of a violation of these provisions shall report such violation to the State
Attorney and/or may file a complaint with the Ethics Commission. Proposers or bidders should reference
Section 18-74 of the City of Miami Code for further clarification.
Page 15 of 58
Request for Proposals (RFP) 207193,2
This language is only a summary of the key provisions of the Cone of Silence. Please review City of
Miami Code Section 18-74 for a complete and thorough description of the Cone of Silence. You may
contact the City Clerk at 305-250-5360, to obtain a copy of same.
1.21. CONFIDENTIALITY - As a political subdivision, the City of Miami is subject to the Florida
Sunshine Act and Public Records Law. If this Contract/Agreement contains a confidentiality provision, it
shall have no application when disclosure is required by Florida law or upon court order.
1.22. CONFLICT OF INTEREST — Bidders/Proposers, by responding to this Formal Solicitation, certify
that to the best of their knowledge or belief, no elected/appointed official or employee of the City of Miami
is financially interested, directly or indirectly, in the purchase of goods/services specified in this Formal
Solicitation. Any such interests on the part of the Bidder/Proposer or its employees must be disclosed in
writing to the City. Further, you must disclose the name of any City employee who owns, directly or
indirectly, an interest of five percent (5%) or more of the total assets of capital stock in your firm.
1.23. COPYRIGHT OR PATENT RIGHTS — Bidders/Proposers warrant that there has been no violation
of copyright or patent rights in manufacturing, producing, or selling the goods shipped or ordered and/or
services provided as a result of this formal solicitation, and bidders/proposers agree to hold the City
harmless from any and all liability, loss, or expense occasioned by any such violation.
1.24. COST INCURRED BY BIDDER/PROPOSER - All expenses involved with the preparation and
submission of Responses to the City, or any work performed in connection therewith shall be borne by the
Bidder(s)/Proposer(s).
1.25. DEBARMENT AND SUSPENSIONS (Sec 18-107)
(a) Authority and requirement to debar and suspend. After reasonable notice to an actual or prospective
Contractual Party, and after reasonable opportunity for such party to be heard, the City Manager, after
consultation with the Chief Procurement Officer and the city attorney, shall have the authority to debar a
Contractual Party, for the causes listed below, from consideration for award of city Contracts. The
debarment shall be for a period of not fewer than three years. The City Manager shall also have the
authority to suspend a Contractual Party from consideration for award of city Contracts if there is probable
cause for debarment, pending the debarment determination. The authority to debar and suspend contractors
shall be exercised in accordance with regulations which shall be issued by the Chief Procurement Officer
after approval by the City Manager, the city attorney, and the City Commission.
(b) Causes for debarment or suspension. Causes for debarment or suspension include the following:
(1) Conviction for commission of a criminal offense incident to obtaining or attempting to obtain a
public or private Contract or subcontract, or incident to the performance of such Contract or
subcontract.
(2) Conviction under state or federal statutes of embezzlement, theft, forgery, bribery, falsification
or destruction of records, receiving stolen property, or any other offense indicating a lack of business
integrity or business honesty.
(3) Conviction under state or federal antitrust statutes arising out of the submission of Bids or
Proposals.
(4) Violation ^4, ;ontract provisions, which is regarded by the Chief Procurement Of'', �,:r to be
indicative of nonresponsibility. Such violation may include failure without good cause to perform in
accordance with the terms and conditions of a Contract or to perform within the time limits provided in
a Contract, provided that failure to perform caused by acts beyond the control of a party shall not be
considered a basis for debarment or suspension.
(5) Debarment or suspension of the Contractual Party by any federal, state or other governmental
entity.
(6) False certification pursuant to paragraph (c) below.
(7) Found in violation of a zoning ordinance or any other city ordinance or regulation and for
which the violation remains noncompliant.
(8) Found in violation of a zoning ordinance or any other city ordinance or regulation and for
which a civil penalty or fine is due and owing to the city.
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Request for Proposals (RFP) 207193,2
(9) Any other cause judged by the City Manager to be so serious and compelling as to affect the
responsibility of the Contractual Party performing city Contracts.
(c) Certification. All Contracts for goods and services, sales, and leases by the city shall contain a
certification that neither the Contractual Party nor any of its principal owners or personnel have been
convicted of any of the violations set forth above or debarred or suspended as set forth in paragraph (b)(5).
(d) Debarment and suspension decisions. Subject to the provisions of paragraph (a), the City Manager shall
render a written decision stating the reasons for the debarment or suspension. A copy of the decision shall
be provided promptly to the Contractual Party, along with a notice of said parry's right to seek judicial
relief.
1.26. DEBARRED/SUSPENDED VENDORS —An entity or affiliate who has been placed on the State of
Florida debarred or suspended vendor list may not submit a response on a contract to provide goods or
services to a public entity, may not submit a response on a contract with a public entity for the construction
or repair of a public building or public work, may not submit response on leases of real property to a public
entity, may not award or perform work as a contractor, supplier, subcontractor, or consultant under contract
with any public entity, and may not transact business with any public entity.
1.27. DEFAULT/FAILURE TO PERFORM - The City shall be the sole judge of nonperformance, which
shall include any failure on the part of the successful Bidder/Proposer to accept the award, to furnish
required documents, and/or to fulfill any portion of this contract within the time stipulated.
Upon default by the successful Bidder/Proposer to meet any terms of this agreement, the City will notify
the Bidder/Proposer of the default and will provide the contractor three (3) days (weekends and holidays
excluded) to remedy the default. Failure on the contractor's part to correct the default within the required
three (3) days shall result in the Contract being terminated and upon the City notifying in writing the
contractor of its intentions and the effective date of the termination. The following shall constitute default:
A. Failure to perform the work or deliver the goods/services required under the Contract and/or within the
time required or failing to use the subcontractors, entities and personnel as identified and set forth, and to
the degree specified in the Contract.
B. Failure to begin the work under this Contract within the time specified.
C. Failure to perform the work with sufficient workers and equipment or with sufficient materials to
ensure timely completion.
D. Neglecting or refusing to remove materials or perform new work where prior work has been rejected as
nonconforming with the terms of the Contract.
E. Becoming insolvent, being declared bankrupt, or committing any act of bankruptcy or insolvency, or
making an assignment for the benefit of creditors, if the insolvency, bankruptcy, or assignment renders the
successful Bidder/Proposer incapable of performing the work in accordance with and as required by the
Contract.
F. Failure to comply with any of the terms of the Contract in any material respect.
All costs and charges incurred by the City as a result of a default or a default incurred beyond the time
limits stated, together with the cost of complet the work, shall be deducted from any monies due or
which may become due on this Contract.
1.28. DETERMINATION OF RESPONSIVENESS - Each Response will be reviewed to determine if it
is responsive to the submission requirements outlined in the Formal Solicitation. A "responsive" response is
one which follows the requirements of the formal solicitation, includes all documentation, is submitted in
the format outlined in the formal solicitation, is of timely submission, and has appropriate signatures as
required on each document. Failure to comply with these requirements may deem a Response
non -responsive.
1.29. DISCOUNTS OFFERED DURING TERM OF CONTRACT - Discount Prices offered in the
response shall be fixed after the award by the Commission, unless otherwise specified in the Special Terms
and Conditions. Price discounts off the original prices quoted in the response will be accepted from
successful Bidder(s)1Proposer(s) during the term of the contract. Such discounts shall remain in effect for
a minimum of 120 days from approval by the City Commission Any discounts offered by a manufacturer
to Bidder/Proposer will be passed on to the City.
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1.30. DISCREPANCIES, ERRORS, AND OMISSIONS - Any discrepancies, errors, or ambiguities in
the Formal Solicitation or addenda (if any) should be reported in writing to the City's Purchasing
Department. Should it be found necessary, a written addendum will be incorporated in the Formal
Solicitation and will become part of the purchase agreement (contract documents). The City will not be
responsible for any oral instructions, clarifications, or other communications.
A. Order of Precedence — Any inconsistency in this formal solicitation shall be resolved by giving
precedence to the following documents, the first of such list being the governing documents.
1) Addenda (as applicable)
2) Specifications
3) Special Conditions
4) General Terms and Conditions
1.31. EMERGENCY / DISASTER PERFORMANCE - In the event of a hurricane or other emergency
or disaster situation, the successful vendor shall provide the City with the commodities/services defined
within the scope of this formal solicitation at the price contained within vendor's response. Further,
successful vendor shall deliver/perform for the city on a priority basis during such times of emergency.
1.32. ENTIRE BID CONTRACT OR AGREEMENT - The Bid Contract or Agreement consists of this
City of Miami Formal Solicitation and specifically this General Conditions Section, Contractor's Response
and any written agreement entered into by the City of Miami and Contractor in cases involving RFPs,
RFQs, and RFLIs, and represents the entire understanding and agreement between the parties with respect
to the subject matter hereof and supersedes all other negotiations, understanding and representations, if any,
made by and between the parties. To the extent that the agreement conflicts with, modifies, alters or
changes any of the terms and conditions contained in the Formal Solicitation and/or Response, the Formal
Solicitation and then the Response shall control. This Contract may be modified only by a written
agreement signed by the City of Miami and Contractor.
1.33. ESTIMATED QUANTITIES —Estimated quantities or estimated dollars are provided for your
guidance only. No guarantee is expressed or implied as to quantities that will be purchased during the
contract period. The City is not obligated to place an order for any given amount subsequent to the award
of this contract. Said estimates may be used by the City for purposes of determining the low bidder or most
advantageous proposer meeting specifications. The City reserves the right to acquire additional quantities
at the prices bid/proposed or at lower prices in this Formal Solicitation.
1.34. EVALUATION OF RESPONSES
A.Rejection of Responses
The City may reject a Response for any of the following reasons:
1) Bidder/Proposer fails to acknowledge receipt of addenda;
2) Bidder/Proposer mistates or conceals any material fact in the Response ;
3) Response does not conform to the requirements of the Formal Solicitation;
4) Response requires a conditional award that conflicts with the method of award;
:; Response does not include required samples, certificates, licer.5 .:.'as required; and,
6) Response was not executed by the Bidder's/Proposer(s) authorized agent.
The foregoing is not an all inclusive list of reasons for which a Response may be rejected. The City may
reject and re -advertise for all or any part of the Formal Solicitation whenever it is deemed in the best
interest of the City.
B. Elimination From Consideration
1) A contract shall not be awarded to atiy 4person or firm which is in arrears to the City upon any debt or
contract, or which is a defaulter as surety or otherwise upon any obligation to the City.
2) A contract may not be awarded to any person or firm which has failed to perform under the terms and
conditions of any previous contract with the City or deliver on time contracts of a similar nature.
3) A contract may not be awarded to any person or firm which has been debarred by the City in
accordance with the City's Debarment and Suspension Ordinance.
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C. Determination of Responsibility
1) Responses will only be considered from entities who are regularly engaged in the business of providing
the goods/equipment/services required by the Formal Solicitation. Bidder/Proposer must be able to
demonstrate a satisfactory record of performance and integrity; and, have sufficient financial, material,
equipment, facility, personnel resources, and expertise to meet all contractual requirements. The terms
"equipment and organization" as used herein shall be construed to mean a fully equipped and well
established entity in line with the best industry practices in the industry as determined by the City.
2) The City may consider any evidence available regarding the financial, technical and other qualifications
and abilities of a Bidder/Proposer, including past performance (experience) with the City or any other
governmental entity in making the award.
3) The City may require the Bidder(s)/Proposer(s) to show proof that they have been designated as an
authorized representative of a manufacturer or supplier which is the actual source of supply, if required by
the Formal Solicitation.
1.35. EXCEPTIONS TO GENERAL AND/OR SPECIAL CONDITIONS OR SPECIFICATIONS -
Exceptions to the specifications shall be listed on the Response and shall reference the section. Any
exceptions to the General or Special Conditions shall be cause for the bid (IFB) to be considered
non -responsive. It also may be cause for a RFP, RFQ, or RFLI to be considered non -responsive; and, if
exceptions are taken to the terms and conditions of the resulting agreement it may lead to terminating
negotiations.
1.36. F.O.B. DESTINATION - Unless otherwise specified in the Formal Solicitation, all prices
quoted/proposed by the bidder/proposer must be F.O.B. DESTINATION, inside delivery, with all delivery
costs and charges included in the bid/proposal price, unless otherwise specified in this Formal
Solicitation. Failure to do so may be cause for rejection of bid/proposal.
1.37. FIRM PRICES - The bidder/proposer warrants that prices, terms, and conditions quoted in its
response will be firm throughout the duration of the contract unless otherwise specified in the Formal
Solicitation. Such prices will remain firm for the period of performance or resulting purchase orders or
contracts, which are to be performed or supplied over a period of time.
1.38. FIRST -SOURCE HIRING AGREEMENT (Sec. 18-105)
(a) The Commission approves implementation of the first -source hiring agreement policy and requires
as a condition precedent to the execution of service contracts for facilities, services, and/or receipt of grants
and loans, for projects of a nature that create new jobs, the successful negotiation of first -source hiring
agreements between the organization or individual receiving said contract and the authorized representative
unless such an agreement is found infeasible by the city manager and such finding approved by the City
Commission at a public hearing.
(b) For the purpose of this section, the following terms, phrases, words and their derivations shall have
the following meanings:
Authorized representative means the Private Industry Council of South Florida/South Florida Employment
and Training Consortium, or its successor as local recipient of federal and state training and employment
funds.
Facilities means all F:iicly financed projects, including but without limitation, unified dev;;:cpment
projects, municipal public works, and municipal improvements to the extent they are financed through
public money services or the use of publicly owned property.
Grants and loans means, without limitation, urban development action grants (UDAG), economic
development agency construction loans, loans from Miami Capital Development, Incorporated, and all
federal and state grants administered by the city.
Service contracts means contracts for the procurement of servicer, by the city which include professional
services.
Services includes, without limitation, public works improvements, facilities, professional services,
commodities, supplies, materials and'equipment.
(c) The authorized representative shall negotiate each first -source hiring agreement.
(d) The primary beneficiaries of the first -source hiring agreement shall be participants of the city
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training and employment programs, and other residents of the city.
139. FLORIDA MINIMUM WAGE - The Constitution of the State of Florida, Article X, Section 24,
states that employers shall pay employee wages no less than the minimum wage for all hours worked in
Florida: Accordingly; it is the contractor's and its' subcontractor(s) responsibility to understand and
comply with this Florida constitutional minimum wage requirement and pay its employees the current
established hourly minimum wage rate, which is subject to change or adjusted by the rate of inflation using
the consumer price index for urban wage earners and clerical workers, CPI-W, or a successor index as
calculated by the United States Department of Labor. Each adjusted minimum wage rate calculated shall
be determined and published by the Agency Workforce Innovation on September 30th of each year and
take effect on the following January 1 st.
At the time of responding, it is bidder/proposer and his/her subcontractor(s), if applicable, full
responsibility to determine whether any of its employees may be impacted by this Florida Law at any given
point in time during the term of the contract. If impacted, bidder/proposer must furnish employee name(s),
job title(s), job description(s), and current pay rate(s). Failure to submit this information at the time of
submitting a response constitute successful bidder's/proposer's acknowledgement and understanding that
the Florida Minimum Wage Law will not impact its prices throughout the term of contract and waiver of
any contractual price increase request(s). The City reserves the right to request and successful
bidder/proposer must provide for any and all information to make a wage and contractual price increase(s)
determination.
1.40. GOVERNING LAW AND VENUE - The validity and effect of this Contract shall be governed by
the laws of the State of Florida. The parties agree that any action, mediation or arbitration arising out of this
Contract shall take place in Miami -Dade County, Florida.
1.41. HEADINGS AND TERMS - The headings to the various paragraphs of this Contract have been
inserted for convenient reference only and shall not in any manner be construed as modifying, amendine or
affecting in any way the expressed terms and provisions hereof.
1.42. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) - Any
person or entity that performs or assists the City of Miami with a function or activity involving the use or
disclosure of "individually identifiable health information (IIHI) and/or Protected Health Information (PHI)
shall comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the City
of Miami Privacy Standards. HIPAA mandates for privacy, security and electronic transfer standards,
which include but are not limited to:
A. Use of information only for performing services required by the contract or as required by law;
B. Use of appropriate safeguards to prevent non -permitted disclosures;
• C. Reporting.to the City of Miami of any non -permitted use or disclosure;
D. Assurances that any agents and subcontractors agree to the same restrictions and conditions that apply to
the Bidder/Proposer and reasonable assurances that IIHI/PHI will be held confidential;
E. Making Protected Health Information (PHI) available to the customer;
F. Making PHI available to the customer for review and amendment; and incorporating any amendments
requested by the customer;
G. Making PHI available to the City of Miami for an accounting of disclosures; and
H. Making internal practices, books and records related to PHI available to the City of Miami for
compliance audits.
PHI shall maintain its protected status regardless of the form and method of transmission (paper records,
and/or electronic transfer of data). The Bidder/ Proposer must give its customers written notice of its
privacy information practices including specifically, a description of the types of uses and disclosures that
would be made's ith protected health information.
1.43. INDEMNIFICATION - The Contractor shall indemnify and save harmless forever the City, and all
the City's agents, officers and employees from and against all. charges or claims resulting from any bodily
injury, loss of life, or damage to property from any act, omission or neglect, by itself or its employees; the
Contractor shall become defendant in every suit brought for any of such causes of action against the City or
the City's officials, agents and employees; the Contractor shall further indemnify City as to all costs,
attomey's fees, expenses and liabilities incurred in the defense of any such claims and any resulting
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1.52. NO PARTNERSHIP OR JOINT VENTURE - Nothing contained in this Contract will be deemed
or construed to create a partnership or joint venture between the City of Miami and Contractor, or to create
any other similar relationship between the parties.
1.53. NONCONFORMANCE TO CONTRACT CONDITIONS - Items may betested for compliance
with specifications under the direction of the Florida Department of Agriculture and Consumer Services or
by other appropriate testing Laboratories as determined by the City. The data derived from any test for
compliance with specifications is public record and open to examination thereto in accordance with
Chapter 119, Florida Statutes. Items delivered not conforming to specifications may be rejected and
returned at Bidder's/Proposer's expense. These non -conforming items not delivered as per delivery date in
the response and/or Purchase Order may result in bidder/proposer being found in default in which event
any and all re -procurement costs may be charged against the defaulted contractor. Any violation of these
stipulations may also result in the supplier's name being removed from the City of Miami's Supplier's list.
1.54. NONDISCRIMINATION —Bidder/Proposer agrees that it shall not discriminate as to race, sex,
color, age, religion, national origin, marital status, or disability in connection with its performance under
this formal solicitation. Furthermore, Bidder/Proposer agrees that no otherwise qualified individual shall
solely by reason of his/her race, sex, color, age, religion; national origin, marital status or disability be
excluded from the participation in, be denied benefits of, or be subjected to, discrimination under any
program or activity.
In connection with the conduct of its business, including performance of services and employment of
personnel, Bidder/Proposer shall not discriminate against any person on the basis of race, color, religion,
disability, age, sex, marital status or national origin. All persons having appropriate qualifications shall be
afforded equal opportunity for employment.
1.55. NON-EXCLUSIVE CONTRACT/ PIGGYBACK PROVISION - At such times as may serve its
best interest, the City of Miami reserves the right to advertise for, receive, and award additional contracts
for these herein goods and/or services, and to make use of other competitively bid (governmental)
contracts, agreements, or other similar sources for the purchase of these goods and/or services as may be
available.
It is hereby agreed and understood that this formal solicitation does not constitute the exclusive rights of
the successful bidders)/proposer(s) to receive all orders that may be generated by the City in conjunction
with this Formal Solicitation.
In addition, any and all commodities, equipment, and services required by the City in conjunction with
construction projects are solicited under a distinctly different solicitation process and shall not be purchased
under the terms, conditions and awards rendered under this solicitation, unless such purchases are
determined to be in the best interest of the City.
1.56. OCCUPATIONAL LICENSE - Any person, firm, corporation or joint venture, with a business
location in the City of Miami and is submitting a Response under this Formal Solicitation shall meet the
City's Occupational License Tax requirements in accordance with Chapter 31.1, Article I of the City of
Miami Charter. Others with a location outside the City of Miami shall meet their local Occupational
License Tax requirements. A copy of the license must be submitted with the response; however, the City
may at its sole option a^'1 in its best interest allow the Bidder/Proposer to supply the license tn. the City
during the evaluation',.:: Aiod, but prior to award.
1.57. ONE PROPOSAL - Only one (1) Response from an individual, firm, partnership, corporation or
joint venture will be considered in response to this Formal Solicitation. When submitting an alternate
response, please refer to the herein condition for "Alternate Responses May Be Considered".
1.58. OWNERSHIP OF DOCUMENTS - It is understood by and between the parties that any documents,
records, files, or any other matter whatsoever which is given by the City to the successful Bidder/Proposer
pursuant to this formal solicitation shall at all times remain the pfoperty of the City and shall not be used by
the Bidder/Proposer for any other purposes whatsoever without the written consent of the City.
1.59. PARTIAL INVALIDITY - If any provision of this Contract or the application thereof to any person
or circumstance shall to any extent be held invalid, then the remainder of this Contract or the application of
such provision to persons or circumstances other than those as to which it is held invalid shall not be
affected thereby, and each provision of this Contract shall be valid and enforced to the fullest extent
permitted by law.
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1.60. PERFORMANCE/PAYMENT BOND —A Contractor may be required to furnish a
Performance/Payment Bond as part of the requirements of this Contract, in an amount equal to one hundred
percent (100%) of the contract price.
1.61. PREPARATION OF RESPONSES (HARDCOPY FORMAT) —Bidders/Proposers are expected to
examine the specifications, required delivery, drawings, and all special and general conditions. All
bid/proposed amounts, if required, shall be either typewritten or entered into the space provided with ink.
Failure to do so will be at the Bidder's/Proposer's risk.
A. Each Bidder/Proposer shall furnish the information required in the Formal Solicitation. The
Bidder/Proposer shall sign the Response and print in ink or type the name of the Bidder/Proposer, address,
and telephone number on the face page and on each continuation sheet thereof on which he/she makes an
entry, as required.
B. If so required, the unit price for each unit offered shall be shown, and such price shall include
packaging, handling and shipping, and F.O.B. Miami delivery inside City premises unless otherwise
specified. Bidder/Proposer shall include in the response all taxes, insurance, social security, workmen's
compensation, and any other benefits normally paid by the Bidder/Proposer to its employees. If
applicable, a unit price shall be entered in the "Unit Price" column for each item. Based upon estimated
quantity, an extended price shall be entered in the "Extended Price" column for each item offered. In case
of a discrepancy between the unit price and extended price, the unit price will be presumed correct.
C. The Bidder/Proposer must state a definite time, if required, in calendar days for delivery of goods
and/or services.
D. The Bidder/Proposer should retain a copy of all response documents for future reference.
E. All responses, as described, must be fully completed and typed or printed in ink and must be signed in
ink with the firm's name and by an officer or employee having authority to bind the company or firm by
his/her signature. Bids/Proposals having any erasures or corrections must be initialed in ink by person
signing the response or the response may be rejected.
F. Responses are to remain valid for at least 180 days. Upon award of a contract, the content of the
Successful Bidder's/Proposer's response may be included as part of the contract, at the City's discretion.
G. The City of Miami's Response Forms shall be used when Bidder/Proposer is submitting its response in
hardcopy format. Use of any other forms will result in the rejection of the response. IF SUBMITTING
HARDCOPY FORMAT, THE ORIGINAL AND THREE (3) COPIES OF THESE SETS OF FORMS,
UNLESS OTHERWISE SPECIFIED, AND ANY REQUIRED ATTACHMENTS MUST BE
RETURNED TO THE CITY OR YOUR RESPONSE MAY BE DEEMED NON -RESPONSIVE.
1.62. PRICE ADJUSTMENTS — Any price decrease effectuated during the contract period either by
reason of market change or on the part of the contractor to other customers shall be passed on to the City of
Miami.
1.63. PRODUCT SUBSTITUTES - In the event a particular awarded and approved manufacturer's
product becomes unavailable during the term of the Contract, the Contractor awarded that item may
arrange with the City's authorized representative(s) to supply a substitute product at the awarded price or
lower, provided that a sample is approved in'y,'vance of delivery and that the new product meets or exceeds
all quality requirements.
1.64. CONFLICT OF INTEREST, AND UNETHICAL BUSINESS PRACTICE PROHIBITIONS -
Contractor represents and warrants to the City that it has not employed or retained any person or company
employed by the City to solicit or secure this Contract and that it has not offered to pay, paid, or agreed to
pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in
connection with, the award of this Contract.
1.65.`PROMP tPAYMENT —Bidders/Proposers may offer a cash discount for prompt payment; however,
discounts shall not be considered in determining the lowest net cost for response evaluation purposes.
Bidders/Proposers are required to provide their prompt payment terms in the space provided on the Formal
Solicitation. If no prompt payment discount is being offered, the Bidder/Proposer must enter zero (0) for
the percentage discount to indicate no discount. If the Bidder/Proposer fails to enter a percentage, it is
understood and agreed that the terms shall be 2% 20 days, effective after receipt of invoice or final
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Request for Proposals (RFP) 207193,2
acceptance by the City, whichever is later.
When the City is entitled to a cash discount, the period of computation will commence on the date of
delivery, or receipt of a correctly completed invoice, whichever is later. If an adjustment in payment is
necessary due to damage, the cash discount -period shall commence on the date final approval for payment
is authorized. If a discount is part of the contract, but the invoice does not reflect the existence of a cash
discount, the City is entitled to a cash discount with the period commencing on the date it is determined by
the City that a cash discount applies.
Price discounts off the original prices quoted on the Price Sheet will be accepted from successful
bidders/proposers during the term of the contract.
1.66. PROPERTY - Property owned by the City of Miami is the responsibility of the City of Miami. Such
property furnished to a Contractor for repair, modification, study, etc., shall remain the property of the City
of Miami. Damages to such property occurring while in the possession of the Contractor shall be the
responsibility of the Contractor. Damages occurring to such property while in route to the City of Miami
shall be the responsibility of the Contractor. In the event that such property is destroyed or declared a total
loss, the Contractor shall be responsible for replacement value of the property at the current market value,
less depreciation of the property, if any.
1.67. PROVISIONS BINDING - Except as otherwise expressly provided in the resulting Contract, all
covenants, conditions and provisions of the resulting Contract shall be binding upon and shall inure to the
benefit of the parties hereto and their respective heirs, legal representatives, successors and assigns.
1.68. PUBLIC ENTITY CRIMES - A person or affiliate who has been placed on the convicted vendor list
following a conviction for a public entity crime may not submit a response on a contract to provide any
goods or services to a public entity, may not submit a response on a contract with a public entity for the
construction or repair of a public building or public work, may not submit responses on leases of real
property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or
consultant under a contract with any public entity, and may not transact business with any public entity in
excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of 36
months from the date of being placed on the convicted vendor list.
1.69. PUBLIC RECORDS - Contractor understands that the public shall have access, at all reasonable
times, to all documents and information pertaining to City contracts, subject to the provisions of Chapter
119, Florida Statutes, and City of Miami Code, Section 18, Article III, and agrees to allow access by the
City and the public to all documents subject to disclosure under applicable law. Contractor's failure or
refusal to comply with the provision of this section shall result in the immediate cancellation of this
Contract by the City.
1.70. QUALITY OF GOODS, MATERIALS, SUPPLIES, PRODUCTS, AND EQUIPMENT - All
materials used in the manufacturing or construction of supplies, materials, or equipment covered by this
solicitation shall be new. The items bid/proposed must be of the latest make or model, of the best quality,
and of the highest grade of workmanship, unless as otherwise specified in this Solicitation.
1.71. QUALITY OF WORK/SERVICES - The work/services performed must be of the highest quality
and workmanship. Materials fumished to complete the service shall be new and of the highest quality
except as otherwise specified in this Solicitation.
1.72. REMEDIES PRIOR TO AWARD (Sec. 18-106) - If prior to Contract award it is determined that a
formal solicitation or proposed award is in violation of law, then the solicitation or proposed award shall be
cancelled by the City Commission, the City Manager or the Chief Procurement Officer, as may be
applicable, or revised to comply with the law.
1.73. RESOLUTION OF CONTRACT DISPUTES (Sec. 18-105)
(a) Authority to resolve Contract diSyt^tes. The City Manager, after obtaining the approval of the'city
attorney, shall have the authority to resolve controversies between the Contractual Party and the city which
arise under, or by virtue of, a Contract between them; provided that, in cases involving an amount greater
than $25,000, the City Commission must approve the City Manager's decision. Such authority extends,
without limitation, to controversies based upon breach of Contract, mistake, misrepresentation or lack of
complete performance, and shall be invoked by a Contractual Party by submission of a protest to the City
Manager.
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(b) Conn -act dispute decisions. If a dispute is not resolved by mutual consent, the City Manager shall
promptly render a written report statine the reasons for the action taken by the City Commission or the City
Manager which shall be final and conclusive. A copy of the decision shall be immediately provided to the
protesting party, along with a notice of such party's right to seek judicial relief, provided that the protesting
parry shall not be entitled to such judicial relief without first having followed the procedure set forth in this
section.
1.74. RESOLUTION OF PROTESTED SOLICITATIONS AND AWARDS (Sec. 18-104)
(a) Right to protest. The following procedures shall be used for resolution of protested solicitations and
awards except for purchases of goods, supplies, equipment, and services, the estimated cost of which does
not exceed S25,000.
Protests thereon shall be governed by the Administrative Policies and Procedures of Purchasing.
1.Protest of Solicitation.
i. Any prospective proposer who perceives itself aggrieved in connection with the solicitation of a Contract
may protest to the Chief Procurement Officer. A written notice of intent to file a protest shall be filed with
the Chief Procurement Officer within three days after the Request for Proposals, Request for Qualifications
or Request for Letters of Interest is published in a newspaper of general circulation. A notice of intent to
file a protest is considered filed when received by the Chief Procurement Officer; or
ii. Any prospective bidder who intends to contest the Solicitation Specifications or a solicitation may
protest to the Chief Procurement Officer. A written notice of intent to file a protest shall be filed with the
Chief Procurement Officer within three days after the solicitation is published in a newspaper of general
circulation. A notice of intent to file a protest is considered filed when received by the Chief Procurement
Officer.
2. Protest of Award.
i. A written notice of intent to file a protest shall be filed with the Chief Procurement Officer within two
days after receipt by the proposer of the notice of the City Manager's recommendation for award of
Contract, which will be posted on the City of Miami Purchasing Department website, in the Supplier
Corner, Current Solicitations and Notice of Recommendation of Award Section. The notice of the City
Manager's recommendation can be found by selecting the details of the solicitation and is listed as
Recommendation of Award Posting Date and Recommendation of Award To fields. If -various" is
indicated in the Recommendation of Award To field, the Bidder/Proposer must contact the buyer for that
solicitation to obtain the suppliers name. It shall be the responsibility of the Bidder/Proposer to check this
section of the website daily after responses are submitted to receive the notice; or
ii. Any actual Responsive and Responsible Bidder whose Bid is lower than that of the recommended bidder
may protest to the Chief Procurement Officer. A written notice of intent to file a protest shall be filed with
the Chief Procurement Officer within two days after receipt by the bidder of the notice of the city's
determination of non responsiveness or non responsibility. The receipt by bidder of such notice shall be
confirmed by the city by facsimile or electronic mail or U.S. mail, return receipt requested. A notice of
intent to file a protest is considered filed when received by the Chief Procurement Officer.
iii. A written protest based on any of the foregoing must be submitted to the Chief Procurement Officer
within five (5) dayr; after the date the notice of protest was filed. A written protest is cons"tered filed when
received by the C..;:.'f Procurement Officer.
The written protest may not challenge the relative weight of the evaluation criteria or the formula for
assigning points in making an award determination.
The written protest shall state with particularity the specific facts and law upon which the protest of the
solicitation or the award is based, and shall include all pertinent documents and evidence and shall be
accompanied by the required Filing Fee as provided in subsection (f). This shall form the basis for review
of the written protest and no facts, grounds, documentation dr evidence not contained in the protester's
submission to the Chief Procurement Officer at the time of filing the protest shall be permitted in the
consideration of the written protest.
No time will be added to the above limits for service by mail. In computing any period of time prescribed
or allowed by this section, the day of the act, event or default from which the designated period of time
begins to run shall not be included. The last day of the period so computed shall be included unless it is a
Saturday, Sunday or legal holiday in which event the period shall run until the end of the next day which is
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Request for Proposals (RFP) 207193.2
neither a Saturday, Sunday or legal holiday. Intermediate Saturdays, Sundays and legal holidays shall be
excluded in the computation of the time for filing.
(b) Authority to resolve protests. The Chief Procurement Officer shall have the authority, subject to the
approval of the City Manager and the city attorney, to settle and resolve any written protest. The Chief
Procurement Officer shall obtain the requisite approvals and communicate said decision to the protesting
party and shall submit said decision to the City Commission within 30 days after he/she receives the
protest. In cases involving more than $25,000, the decision of the Chief Procurement Officer shall be
submitted for approval or disapproval thereof to the City Commission after a favorable recommendation by
the city attorney and the City Manager.
(c) Compliance with filing requirements. Failure of a party to timely file either the notice of intent to file a
protest or the written protest, together with the required Filing Fee as provided in subsection (f), with the
Chief Procurement Officer within the time provided in subsection (a), above, shall constitute a forfeiture of
such party's right to file a protest pursuant to this section. The protesting party shall not be entitled to seek
judicial relief without first having followed the procedure set forth in this section
(d) Stay of Procurements during protests. Upon receipt of a written protest filed pursuant to the
requirements of this section, the city shall not proceed further with the solicitation or with the award of the
Contract until the protest is resolved by the Chief Procurement Officer or the City Commission as provided
in subsection (b) above, unless the City Manager makes a written determination that the solicitation process
or the Contract award must be continued without delay in order to avoid an immediate and serious danger
to the public health, safety or welfare.
(e) Costs. All costs accruing from a protest shall be assumed by the protestor.
(f) Filing Fee. The written protest must be accompanied by a filing fee in the form of a money order or
cashier's check payable to the city in an amount equal to one percent of the amount of the Bid or proposed
Contract, or $5000.00, whichever is Tess, which filing fee shall guarantee the payment of all costs which
may be adjudged against the protestor in any administrative or court proceeding. If a protest is upheld by
the Chief Procurement Officer and/or the City Commission, as applicable, the filing fee shall be refunded
to the protestor less any costs assessed under subsection (e) above. If the protest is denied, the filing fee
shall be forfeited to the city in lieu of payment of costs for the administrative proceedings as prescribed by
subsection (e) above.
1.75. SAMPLES - Samples of items, when required, must be submitted within the time specified at no
expense to the City. If not destroyed by testing, bidder(s)/proposer(s) will be notified to remove samples,
at their expense, within 30 days after notification. Failure to remove the samples will result in the samples
becoming the property of the City.
1.76. SELLING, TRANSFERRING OR ASSIGNING RESPONSIBILITIES - Contractor shall not sell,
assign, transfer or subcontract at any time during the term of the Contract, or any part of its operations, or
assign any portion of the performance required by this contract, except under and by virtue of written
permission granted by the City through the proper officials, which may be withheld or conditioned, in the
City's sole discretion.
1.77. SERVICE AND WARRANTY —When specified, the bidder/proposer shall define all warranty,
service and replacements that will be provh'?, d. Bidders/Proposer must explain on the Response to what
extent warranty and service facilities are available. A copy of the manufacturer's warranty, if applicable,
should be submitted with your response.
1.78. SILENCE OF SPECIFICATIONS - The apparent silence of these specifications and any
supplemental specification as to any detail or the omission from it of detailed description concerning any
point shall be regarded as meaning that only the best commercial practices are to prevail and that only
materials of first quality and correct type, size and design are to be used. All workrrinnship and services is
to be first gtial ty.
All interpretations of these specifications shall be made upon the basis of this statement.
If your firm has a current contract with the State of Florida, Department of General Services, to supply the
items on this solicitation, the bidder/proposer shall quote not more than the contract price; failure to comply
with this request will result in disqualification of bid/proposal.
1.79. SUBMISSION AND RECEIPT OF RESPONSES - Responses shall be submitted electronically via
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Request for Proposals (RFP) 207193,2
the Oracle System or responses may be submitted in hardcopy format to the City Clerk, City Hall, 3500
Pan American Drive, Miami, Florida 33133-5504, at or before, the specified closing date and time as
designated in the IFB, RFP, RFQ, or RFLI. NO EXCEPTIONS. Bidders/Proposers are welcome to attend
the solicitation closing; however, no award will be made at that time.
A. Hardcopy responses shall be enclosed in a sealed envelope, box package. The face of the envelope,
box or package must show the hour and date specified for receipt of responses, the solicitation number and
title, and the name and return address of the Bidder/Proposer. Hardcopy responses not submitted on the
requisite Response Forms may be rejected. Hardcopy responses received at any other location than the
specified shall be deemed non -responsive.
Directions to City Hall:
FROM THE NORTH: I-95 SOUTH UNTIL IT TURNS INTO US1. USI SOUTH TO 27TH AVE..
TURN LEFT, PROCEED SOUTH TO SO. BAYSHORE DR. (3RD TRAFFIC LIGHT), TURN LEFT, 1
BLOCK TURN RIGHT ON PAN AMERICAN DR. CITY HALL IS AT THE END OF PAN
AMERICAN DR. PARKING IS ON RIGHT.
FROM THE SOUTH: USI NORTH TO 27TH AVENUE, TURN RIGHT, PROCEED SOUTH TO SO.
BAYSHORE DR. (3RD TRAFFIC LIGHT), TURN LEFT, 1 BLOCK TURN RIGHT ON PAN
AMERICAN DR. CITY HALL IS AT THE END OF PAN AMERICAN DR. PARKING IS ON RIGHT.
B. Facsimile responses will not be considered.
C. Failure to follow these procedures is cause for rejection of bid/proposal.
D. The responsibility for obtaining and submitting a response on or before the close date is solely and
strictly the responsibility of Bidder/Proposer. The City of Miami is not responsible for delays caused by
the United States mail delivery or caused by any other occurrence. Responses received after the
solicitation closing date and time will be returned unopened, and will not be considered for award.
E. Late responses will be rejected.
F. All responses are subject to the conditions specified herein. Those which do not comply with these
conditions are subject to rejection.
G. Modification of responses already submitted will be considered only if received at the City before the
time and date set for closing of solicitation responses. All modifications must be submitted via the Oracle
System or in writing. Once a solicitation closes (closed date and/or time expires), the City will not consider
any subsequent submission which alters the responses.
H. If hardcopy responses are submitted at the same time for different solicitations, each response must be
placed in a separate envelope, box, or package and each envelope, box or package must contain the
information previously stated in 1.82.A.
1.80. TAXES - The City of Miami is exempt from any taxes imposed by the State and/or Federal
Government. Exemption certificates will be provided upon request. Notwithstanding, Bidders/Proposers
should be aware of the fact that all materials and supplies which are purchased by the Bidder/Proposer for
the completion of the contract is subject to the Florida State Sales Tax in accordance with Section 212.08,
Florida Statutes, as amended and all amendments thereto and shallir; paid solely by the Bidder/Proposer.
1.81. TERMINATION —The City Manager on behalf of the City of Miami reserves the right to terminate
this contract by written notice 10 the contractor effective the date specified in the notice should any of the
following apply:
A. The contractor is determined by the City to be in breach of any of the terms and conditions of the
contract.
B. The City has determined that suchtermination will be in the best interest of the City to terminate the
contract for its own convenience;
C. Funds are not available to cover the cost of the goods and/or services. The City's obligation is
contingent upon the availability of appropriate funds.
1.82. TERMS OF PAYMENT - Payment will be made by the City after the goods and/or services
awarded to a Bidder/Proposer have been received, inspected, and found to comply with award
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Request for Proposals (RFP) 207193,2
specifications, free of damage or defect, and properly invoiced. No advance payments of any kind will be
made by the City of Miami.
Payment shall be made after delivery, within 45 days of receipt of an invoice and authorized inspection
and acceptance ofthe goods/services and pursuant to Section 218.74, Florida Statutes and other applicable
law.
1.83. TIMELY DELIVERY - Time will be of the essence for any orders placed as a result of this
solicitation. The City reserves the right to cancel such orders, or any part thereof, without obligation, if
delivery is not made within the time(s) specified on their Response. Deliveries are to be made during
regular City business hours unless otherwise specified in the Special Conditions.
1.84. TITLE - Title to the goods or equipment shall not pass to the City until after the City has accepted
the goods/equipment or used the goods, whichever comes first.
1.85.TRADE SECRETS EXECUTION TO PUBLIC RECORDS DISCLOSURE- All Responses
submitted to the City are subject to public disclosure pursuant to Chapter 119, Florida Statutes. An
exception may be made for "trade secrets."
If the Response contains information that constitutes a "trade secret", all material that qualifies for
exemption from Chapter 119 must be submitted in a separate envelope, clearly identified as "TRADE
SECRETS EXCEPTION," with your firm's name and the Solicitation number and title marked on the
outside.
Please be aware that the designation of an item as a trade secret by you may be challenged in court by any
person. By your designation of material in your Response as a "trade secret" you agree to indemnify and
hold harmless the City for any award to a plaintiff for damages, costs or attorney's fees and for costs and
attorney's fees incurred by the City by reason of any legal action challenging your claim.
1.86. UNAUTHORIZED WORK OR DELIVERY OF GOODS- Neither the qualified
Bidder(s)/Proposer(s) nor any of his/her employees shall perform any work or deliver any goods unless a
change order or purchase order is issued and received by the Contractor. The qualified
Bidder(s)/Proposer(s) shall not be paid for any work performed or goods delivered outside the scope of the
contract or any work performed by an employee not otherwise previously authorized.
1.87. USE OF NAME - The City is not engaged in research for advertising, sales promotion, or other
publicity purposes. No advertising, sales promotion or other publicity materials containing information
obtained from this Solicitation are to be mentioned, or imply the name of the City, without prior express
written permission of the City Manager or the City Commission.
1.88. VARIATIONS OF SPECIFICATIONS - For purposes of solicitation evaluation, bidders/proposers
must indicate any variances from the solicitation specifications and/or conditions, no matter how slight. If
variations are not stated on their Response, it will be assumed that the product fully complies with the
City's specifications.
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Request for Proposals (RFP) 207] 93,2
2. Special Conditions
2.1. PURPOSE
The purpose of this Solicitation is to establish a contract, for Claims Administration Services for Workers
Compensation, Liability, and Managed Care Services and, as specified herein, from a source(s) of supply
that will give prompt and efficient service fully compliant with the terms, conditions and stipulations of the
solicitation.
2.2. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL
INFORMATION/CLARIFICATION
Any questions or clarifications concerning this solicitation shall be submitted by email or facsimile to the
Purchasing Department, Attn: Maritza Suarez, CPPB; fax: (305) 400-5025 or
email: msuarez@ci.miami.fl.us. The solicitation title and number shall be referenced on all
correspondence. All questions must be received no later than Tuesday, April 20, 2010 at 3:00 PM Eastern
Standard Time. All responses to questions will be sent to all prospective bidders/proposers in the form on
an addendum. NO QUESTIONS WILL BE RECEIVED VERBALLY OR AFTER SAID DEADLINE.
2.3. TERM OF CONTRACT
The proposer(s) qualified to provide the service(s) requested herein (the "Successful Proposer(s)") shall be
required to execute a contract ("Contract") with the City, which shall include, but not be limited to, the
following terms:
(1) The term of the Contract(s) shall be for three (3) years with an option to renew for five (5) additional
one (1) year periods.
(2) The City shall have the option to extend or terminate the Contract.
Continuation of the contract beyond the initial period is a City prerogative; not a right of the
bidder/proposer. This prerogative will be exercised only when such continuation is clearly in the best
interest of the City.
2.4. CONDITIONS FOR RENEWAL
Each renewal of this contract is subject to the following:
(1) Continued satisfactory performance compliance with the specifications, terms and conditions
established herein.
(2) Availability of funds
2.5. NON -APPROPRIATION OF FUN1s
In the event no funds or insufficient funds are appropriated and budgeted or are otherwise unavailable in
any fiscal period for payments due under this contract, then the City, upon written notice to Contractor or
his assignee of such occurrence, shall have the unqualified right to terminate the contract without any
penalty or expense to the City. No guarantee, warranty or representation is made that any particular or any
project(s) will be awarded to any firm(s).
2.6. MINIMUM QUALIFICATION REQUIREMENTS
Proposer Qualifications
Proposers shall satisfy each of the following requirements cited below. Failure to do so will result in the
Proposal being deemed non -responsive.
For the provision of Part l,Claims Administration Services, part 11, General, Automobile, and
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Request for Proposals (RFP) 207193,2
Professional Liability Claims Administration and Part III, Managed Care Services:
A. Proposer shall have been.in existence and providing the services as described in this RFP for a
minimum of five (5) years; and have sufficient financial support, equipment and organization to insure that
it can satisfactorily execute the services if awarded a Contract under the terms and conditions herein stated.
B. Shall have the ability to effectively interface with the computerized tracking system of the City and
its proposed on-line claims management system, or if Proposer plans to provide its own system, must
provide system and interface with City's system and data.
C. Neither Proposer nor any member, officer, or stockholder of Proposer (s) shall be in arrears or in
default of any debt or contract involving the City, (as a parry to a contract, or otherwise); nor have failed to
perform faithfully on any previous contract with the City.
2.7. CONTRACT EXECUTION
The selected Proposer(s) evaluated and ranked in accordance with the requirements of this Solicitation,
shall be awarded an opportunity to negotiate a contract ("Contract") with the City. The City reserves the
right to execute or not execute, as applicable a Contract with the selected Proposer(s) that is determined to
be most advantageous and in the City's best interest. Such Contract will be furnished by the City, will
contain certain terms as are in the City's best interests, and will be subject to approval as to legal form by
the City Attorney.
2.8. MANDATORY PRE -PROPOSAL CONFERENCE
Potential Proposers are required to attend the Mandatory Pre -Proposal Conference, which will occur
on Monday, April 19, 2010 at 10:00 a.m., at 444 SW 2nd Avenue, loth Floor Large Conference Room,
Miami, Florida. A discussion of the requirements of the solicitation will occur at that time. Each potential
Proposer is required, prior to submitting a Proposal, to acquaint itself thoroughly with any and all
conditions andlor requirements that may in any manner affect the work to be performed. No allowances
will be made because of lack of knowledge of these conditions.
The purpose of the pre -proposal conference is to allow potential Proposers an opportunity to present
questions to staff and obtain clarification of the requirements of the solicitation documents. Because the
City considers the conference to be critical to understanding the solicitation requirements, attendance is
Mandatory. Proposers who arrive more than one-half (1 /2) hour late to the conference shall not be
deemed as having met this mandatory requirement.
FAILURE TO ATTEND SHALL DEEM ANY PROPOSAL FROM UNATTENDING PROPOSER AS
NON -RESPONSIVE.
2.9. FAILURE TO PERFORM
Should it not be possible to reach the contractor or supervisor and/or should remedial action not be taken
within 48 hours .of any failure to perform according to specificat' , the City reserves the right to declare
Contractor in default of the contract or make appropriate reductions in the contract payment.
2.10. INSURANCE REQUIREMENTS
INDEMNIFICATION
Bidder shall pay on behalf of, indemnify and save City and its officials harmless, from and against any and
all claims, liabilities, losses, and causes of action, which may arise out of bidder's performance under thy,
provisions of the contract, including all acts or omissions to act on the part of bidder, including any person
performing under this Contract for or on bidder's behalf, provided that any such claims, liabilities, losses
and causes of such action are not attributable to the negligence or misconduct of the City and, from and
against any orders, judgments or decrees which may be entered and which may result from this Contract,
unless attributable to the negligence or misconduct of the City, and from and against all costs, attomeys'
fees, expenses and liabilities incurred in the defense of any such claim, or the investigation thereof.
Page 30 of 58
Request for Proposals (RFP) 207193,2
determined for any reason that the Contractor was not in default or (2) the Contractor's failure to perform is
without his or his subcontractor's control, fault or negligence, the termination will be deemed to be a
termination for the convenience of the City of Miami.
B. FOR CONVENIENCE
The City Manager may terminate this Contract, in whole or in part, upon 30 days prior written notice when
it is in the best interests of the City of Miami. If this Contract is for supplies, products, equipment, or
software, and so terminated for the convenience by the City of Miami the Contractor will be compensated
in accordance with an agreed upon adjustment of cost. To the extent that this Contract is for services and so
terminated, the City of Miami shall be liable only for payment in accordance with the payment provisions
of the Contract for those services rendered prior to termination.
2.14. ADDITIONAL TERMS AND CONDITIONS
No additional terms and conditions included with the solicitation response shall be evaluated or
considered, and any and all such additional terms and conditions shall have no force or effect and are
inapplicable to this solicitation. If submitted either purposely, through intent or design, or inadvertently,
appearing separately in transmittal letters, specifications, literature, price lists or warranties, it is understood
and agreed that the General and Special Conditions in this solicitation are the only conditions applicable to
this solicitation and that the bidder's/proposer's authorized signature affixed to the bidder's/proposer's
acknowledgment form attests to this.
2.15. PRIMARY CLIENT (FIRST PRIORITY)
The successful bidder(s)/proposer(s) agree upon award of this contract that the City of Miami shall be its
primary client and shall be serviced first during a schedule conflict arising between this contract and any
other contract successful bidder(s)/proposer(s) may have with any other cities and/or counties to perform
similar services as a result of any catastrophic events such as tornadoes, hurricanes, severe storms or any
other public emergency impacting various areas during or approximately the same time.
2.16. UNAUTHORIZED WORK
The Successful Proposer(s) shall not begin work until a Purchase Order is received.
2.17. CHANGES/ALTERATIONS
Proposer may change or withdraw a Proposal at any time prior to Proposal submission deadline; however,
no oral modifications will be allowed. Written modifications shall not be allowed following the proposal
deadline.
2.18. COMPENSATION PROPOSAL
Each Proposer shall detail any and all fees and costs to provide the required services as listed herein, and in
accordance with the Submission Requirement for each of the Part(s) proposer is submitting a proposal
for. Proposer shall additionally provide a detailed list of all costs to provide all services as detailed in
Section III Scope of Services, as proposed. The City reserves the right to add or delete any service, at any
time. Should the City determine to add an additional service for which pricing was not previously secured,
the City shall seek the Successful Proposer to provide reasonable oost(s) for same. Should the City
determine the pricing unreasonab ., +he City reserves the right to negotiate cost(s) or seek another vendo.`
for the provision of said service(s).
Failure to submit compensation proposal as required shall disqualift Proposer from consideration.
2.19. EVALUATION/SELECTION PROCESS AND CONTRACT AWARD
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Request for Proposals (RFP) 207193,2
The procedure for response evaluation, selection and award is as follows:
(1) Solicitation issued.
(2) Receipt of responses
(3) Opening and listing of all responses received
(4) Purchasing staff will review each submission for compliance with the submission requirements of the
Solicitation, including verifying that each submission includes all documents required.
(5) An Evaluation Committee, appointed by the City Manager, comprised of appropriate City Staff and
members of the community, as deemed necessary, with the appropriate technical expertise and/or
knowledge, shall meet to evaluate each response in accordance with the requirements of this Solicitation
and based upon the evaluation criteria as specified herein.
(6) The Evaluation Committee reserves the right, in its sole discretion, to request Proposers to make oral
presentations before the Committee as part of the evaluation process. The presentation may be scheduled at
the convenience of the Evaluation Committee and shall be recorded.
(7) The Evaluation Committee reserves the right to rank the Proposals and shall submit its
recommendation to the City Manager for acceptance. If the City Manager accepts the Committee's
recommendation, the City Manager's recommendation for award of contract will be posted on the City of
Miami Purchasing Department website, in the Supplier Corner, Current Solicitations and Notice of
Recommendation of Award Section. The notice of the City Manager's recommendation can be found by
selecting the details of the solicitation and is listed as Recommendation of Award Posting Date and
Recommendation of Award To fields. If "various" is indicated in the Recommendation of Award To field,
the Bidder/Proposer must contact the buyer for that solicitation to obtain the suppliers name. The City
Manager shall make his recommendation to the City Commission requesting the authorization to negotiate
and/or execute an agreement with the recommended Proposer(s). No Proposer(s) shall have any rights
against the City arising from such negotiations or termination thereof.
(8) The City Manager reserves the right to reject the Committee's recommendation, and instruct the
Committee to re-evaluate and make another recommendation, reject all proposals, or recommend that the
City Commission reject all proposals.
(9) The City Commission shall consider the City Manager's and Evaluation Committees'
recommendation(s) and, if appropriate and required, approve the City Manager's recommendation(s). The
City Commission may also reject any or all response.
(10) If the City Commission approves the recommendations, the City will enter into negotiations with the
selected Proposer(s) for a contract for the required services. Such negotiations may result in contracts, as
deemed appropriate by the City Manager.
(11) The City Commission shall review and approve the negotiated Contract with the selected
Proposer(s).
2.20. ADDITIONAL SERVICES
Services not specifically identified in this request may be added to any resultant contract upon successful
negotiation and r itual consent of the contracting parties.
2.21. RECORDS
During the contract period, and for a least five (5) subsequent years thereafter, Successful Proposer shall
provide City access to all files and records maintained on the City's behalf.
2.22. ATTACHMENTS
A. Managed Care Contract with AmeriSys
B. Third Party Claim Administration Contract with Gallagher Bassett
C. Labor Agreements with
1. FOP
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Request for Proposals (RFP) 207193,2
2. ]AFF
3. AFSCME
4. CIGU
D. Background Information on Workers Compensation Claims
Please be advised that duc to the voluminous nature of Attachments A, B, and C, the aforementioned
Attachments will be distributed at the Mandatory Pre -Proposal Conference. Attachment D is
included with this RFP.
2.23. TRUTH IN NEGOTIATION CERTIFICATE
Execution of the resulting agreement by the Successful Proposer shall act as the execution of
truth -in -negotiation certificate stating that wage rates and other factual unit costs supporting the
compensation of the resulting Agreement are accurate, complete, and current at the time of contracting.
The original contract price and any additions thereto shall be adjusted to exclude any significant sums by
which City determines the contract price was increased due -to inaccurate, incomplete, or non -current wage
rates and other factual unit costs. All such contract adjustments shall be made within one (1) year
following the end of the Agreement.
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Request for Proposals (RFP) 207193,2
3. Specifications
3.1. SPECIFICATIONS/SCOPE OF WORK
3.1 BACKGROUND
It is the City's intention to establish, on behalf of the Department of Risk Management, a term Contract for
the provision of various services described below. The services required under this RFP will be divided
into three (3) Parts:
Part I Services: Workers Compensation Claims Administration Services
Part II Services: General, Automobile and Professional Liability Claims Administration Services
Part III Services: Managed Care Services
While the City is seeking a Proposer to provide comprehensive services to meet all of its needs indicated
above, Proposer may propose to provide either Part I, Part II, and/or Part III services. The City reserves the
right to award Part I, Part I1, and/or Part III services to a Successful Proposer(s), whichever is in the best
interests of the City.
The Contract for the provision of Part I, Part I1, and/or Part 1I1 services is to be for an initial period of three
(3) years, with five (5) one (1) year renewal options. Proposals not including an all inclusive guaranteed
annual fee for three years for all specified services, except for Managed Care, will not be considered. The
City's current Third Party Claims Administrator is Gallagher Bassett Services, Inc. and Managed Care
Administrator is AmeriSys. They have been under contract to provide services since October, 2003.
The Department of Risk Management provides optimum service to employees and the public through a
variety of interrelated health, safety and liability/loss control programs. The provision of these crucial
prevention -oriented programs greatly enhances the working environment and serves as an incentive for
employee recruitment, retention and satisfaction, while protecting the City's assets, employees and
citizens. Its objectives include goals to eliminate, where possible, the threat of accident and other forms of
liability, and where it is possible to eliminate the risk, to at the very least, reduce the possibility of an
accident or risk occurring.
Currently, the City has approximately 4,486 employees, including approximately 1,190 sworn law
enforcement officers and 635 sworn fire personnel, temporary and part-time employees. There are four (4)
Labor Unions in the City: Fraternal Order of Police (FOP), American Federation of State County and
Municipal Employees (AFSCME), International Association of Fire Fighters (IAFF), and American
Federation of State, County and Municipal Employees 79 (AFSCME). Labor unions represent eighty-five
(85%) of the City's workforce. Any assessment of Risk Management must consider each of the existing
labor contracts for the above as it affects employees related to workers compensation and group health
benefits. See attachment C.
The City has created and maintains a Self -Insurance program. The Self Insurance Program provides
protection to the City for all property and casualty loss exposures, workers' compensation claims and
provides group health benefits to active and retired employees. In addition, Risk Management cares for the
City's injured workers. Attention is focused in the areas of safer' awareness, prevention, treatment of
injured workers, rehabilitation, job placement, education, and .... mmunications with the employees and the
departments.
Guidelines for the treatment and care of injured employees are based on Florida Statutes 440 which govern
the State's Workers' Compensation Law. However, as a result of bargaining agreements, additional
benefits are granted depending on the bargaining unit. The Proposer must become familiar with the
existing labor contracts. These contracts will be provided to prospective proposers at the Mandatory
Pre -Proposal Conference, due to their bulk.
The City's current claims administrator utilizes Risx Facs claim processing system where all data is
maintained, updated and payments are issued. The adjudication of Worker's Compensation medical bills
and payments to the City's providers are performed through this system. Any computer system/software
proposed must successfully integrate with all other computerized systems used by the current claims
administrator, Finance and other applicable departments throughout the term of the Contract.
Currently, Gallagher Bassett through Citibank provides the City with bank reconciliation reports to
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Request for Proposals (RFP) 207193,2
interface with the City's financial system on a monthly basis. The Successful Proposer(s) shall be
responsible for the conversion of any data necessary should its proposed system not be compatible with the
City's. Any procedures, equipment, software, or any other costs necessary to replace the existing Risx Facs
system and/or connect with the current claims administrator's hardware and software shall be the sole
responsibility of the Successful Proposer(s). Workers' Compensation medical bills, indemnity payments
and all settlement payments are processed through this system. On a monthly basis, Gallagher Bassett
Services provides the City with bank reconciliations for reconciliation with the City's financial
information.
Self Insurance Program
The City is 100% self -insured for Workers' Compensation and maintains a formal Self -Insurance Program
("Program"). The City utilizes the Program to provide protection to the City for all property and casualty
Toss exposures and Workers' compensation claims and to provide group health benefits to its active and
retired employees. Proposers should refer to Attachment Dfor a history of Workers' Compensation claims
of the City for the past three (3) years. There is an excess Workers' Compensation policy in effect since
2/5/01-9/30/09 for injuries which occurred during that period. Although the Program utilizes a single
insurance fund, the scope of Part I of the RFP addresses the area of Workers' Compensation only.
Managed Care Program
Per the provision of Part III services, the City had originally entered into a Managed Care Agreement with
AmeriSys. AmeriSys now provides managed care to the City. This contract will expire October 2011, and
it does not have any further extensions. Under the current extension, the City has the right to procure
managed care services prior to the expiration of final extension. Refer to Attachment A . Reporting
requirements with AmeriSys include the provision of monthly reported claims report; monthly open claims
report; daily DWCI; and weekly status reports.
Safety Program
The City recognizes the importance of a strong Safety Program as a primary tool for mitigating losses. The
City runs a City-wide Safety Program under the Department of Risk Management. The Safety Manager
who develops and implements safety objectives heads the Division of Safety. The development of safe
working conditions and practices are the principal objectives, along with the reduction in work -related
accidents and injuries. Regular safety inspections are performed to reduce and eliminate hazards and ensure
employees are using proper equipment and procedures. Claims investigation and accident analysis are
conducted to locate areas of frequent accidents and pattems. An appropriate educational program has been
established to increase employee awareness of safety and loss prevention. Additionally, driver training
courses are provided to reduce frequency and severity of auto related injuries. It is the expectation of the
Successful Proposer to work closely with the Safety Manager to enhance the Safety Program for the entire
City and all labor groups.
Light Dutv Program
The City has accommodated Light -Duty Programs for injured employees for many years. It is the
expectation of the Successful Proposer to assist in exploring enhancement and development of a
comprehensive Light Duty Program for the entire City and all labor groups.
3.2 SCOPE OF WORK
PART I - W' '.KERS COMPENSATION CLAIMS ADMINISTRATION
The City is seeking Proposals for third party Claims Administration Services by a Successful Proposer
("Claims Administrator") for the City's Workers' Compensation Self -Insurance Program. The Claims
Administrator will provide all specified adjusting services for all claims made against the City for Workers'
Compensation, as well as all other required services, such as administration, computerized claim/loss
statistical information and loss fund reconciliation. Specific services to be provided are outlined in this
RFP. However, the City reserves the right to add additional services as may be deemed necessary.
The Claims Administrator must be prepared to assume the daily activities in the processing and handling
of Workers' Compensation claims. The Claims Administrator shall recommend risk control measures and
safety programs to protect the City's interest. The staff of the Claims Administrator will be required to
work closely with the City Attorney's Office, the Finance Department and other major departments in the
City.
The City is seeking Proposals for third party claims administration services for its self-insurance program.
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Request for Proposals (RFP) 207193,2
The City carries excess workers' compensation coverage (with SIR of $350,000 - $500,000 per claim for
years 2001-2009).
The Claims Administrator must be familiar with and have working knowledge of the Florida Rules of
Workers' Compensation, F.S. 440; Rules for Self -Insurers under the Workers' Compensation Act, Title 4 of
the Department of Insurance; and the Rules of the Division of Workers' Compensation, Title 38,
Department of Labor and Employment Security.
The Claims Administrator shall provide Claims personnel, who shall be available on a 7 day, 24 hour basis
for investigating claims, and must have and maintain an 800 or other toll -free telephone for emergency
service. The Claims Administrator must provide its own office space or facility(s) for its adjuster or staff of
adjusters. Its claims adjusters will have limited settlement authority, and all larger settlements, established
by the City, must be approved by the City.
The Successful Proposer must agree to be responsible to manage Workers' Compensation claims to be
opened within the year(s) following contract execution, along with the current inventory of open files. The
City is seeking a Successful Proposer that will provide claims administration on a "life of relationship
basis."
At this time, Risk Management oversees Workers' Compensation claims administered by the current
claims administrator. The number of personnel utilized by the claims administrator for current claims vs.
future claims includes 6 adjusters, and 2 claims representatives.
The City must be able to access Proposer's system, and Proposer must include any costs of its system in its
Proposal.
A. The Claims Administrator shall be responsible for performing, as a minimum, the following services:
1. Establish reporting procedures which are compatible with the needs and organizational structure of
the City as determined by Risk Management. Notice of injury reports will be submitted to the
administrator paperless format i.e. Internet or E-mail. Establish claims acknowledgment procedures to the
City's satisfaction.
2. Provide necessary forms and instructions for use. Such forms are to include appropriate first reports
of injury with mailing address of claim administrator pre-printed thereon.
3. Designate the number of adjusters necessary to appropriately handle the City's claims.
4. Receive and examine on behalf of the City all reports of employee injury claims.
5. Establish and maintain complete files on each claim.
6. Accept or deny all reported claims for employee's injuries on behalf of the City in accordance with
the applicable Workers' Compensation Law. The decision to controvert a claim must first be discussed
with and approved by Risk Management.
7. Conduct the required investigations deemed necessary as it relates to Workers' Compensation,
including scene investigations and personal claimant contact on all lost time or light duty cases. Contact
with claimants must be attempted within 24 hours of the Administrator's receipt of the claim. Field
investigations and claimant contact mus* ' 'e performed by employees of the Administrator. Independent
adjusters cannot be used to provide the �rvice.
9. Perform job site visits to become familiar with exposures unique to the City.
10. Provide a list every 30 days indicating all employees that are losing time or working in a light -duty or
restricted capacity.
11. Submit a full summary report to Risk Management every 90 days on all claims of the following types:
'a) any clC.iiil in which an employee is not working full -duty
b) total incurred value exceeding $25,000
c) potentially controverted cases
d) cardiovascular claims
e) claims in which settlement (washout) is recommended
12. Prepare and maintain files necessary for legal defense of claims and/or other litigation (such as actions
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Request for Proposals (RFP) 207193,2
for subrogation) or other proceedings.
13. Pay in a timely fashion all claims and expenses from the loss fund account established by the City,
which will be maintained by the Administrator. Fees and civil penalties for late payments are to be paid by
the Administrator unless caused due to late reporting by the City.
14. Pursue all possibilities of subrogation and recovery from the Special Disability Fund.
15. While the City will designate the attorney(s) that provide the defense of claims, the Administrator shall
provide the defense attorney(s) a complete copy of the file in question and monitor and actively participate
in the activities of the defense attomey(s).
16. Attend Workers' Compensation hearings, mediations and Pension Board hearings involving
work -related injuries as requested by the City.
17. Make written recommendations to Risk Management regarding any procedure or condition that should
be examined to prevent future claims, which are revealed during the Administrator's investigation of a
claim.
18. Contact Risk Management by telephone on all claims where the compensability or the relatedness of
the medical expenses on the claim is in question.
19. Contact employees who experience loss time at least every two weeks, for the duration of temporary
total disability payments. When an employee is represented, the attorney shall be contacted when
appropriate. If attomey contact is appropriate, that contact should be on a 60-day basis.
20. Report all lost time and/or questionable cases to the Index Bureau. All lost time shall be re -indexed
every six (6) months.
21. Establish initial reserves within ten (10) days of receipt of the First Report. All files must be reserved
adequately to extend through the expected life of the claim. Although all the necessary facts may not be
available at the onset of a claim, reserves should be adjusted when medical information or investigation
indicates the existing reserve is inadequate or overstated. The following factors shall be considered when
establishing a reserve:
a) the injury;
b) the investigation;
c) medical treatment and costs;
d) projected temporary total disability benefits to be paid;
e) projected permanent partial disability and impairment benefits,
f) and potential use of outside experts (i.e., rehabilitation service providers, attorneys, etc.)
The Administrator shall review the adequacy of reserves at least every three months, and documentation in
the file shall reflect this review.
22. Present in writing all settlements to Risk Management and City Attorney for approval, regardless of the
amount. The injured employee will not be contacted regarding settlement until approval of proposed
settlement is obtained from Risk Management and and/or City_Attomey.
23. Follow all DWC rules when compensation, medical or i u-or benefits are being controverted. The case
must be discussed with Risk Management before the claim is denied.
24. Obtain medical reports as necessary to determine the status of the employee's injury and to verify
disability; coordinate with the City's Managed Care provider.
25. Report all claims involving a fatality to Risk Management immediately. Payments on such files shall
be made in accordance with the Ktorida Workers' Compensation Law andlor governing contractual
agreements. Periodic activity decks shall be performed to ensure that dependents who receive surviv;r's
benefits are still eligible to receive them, and notify Risk Management regarding those activity'checks.
26. Prepare and file with the appropriate State agency all applications required for the City's qualification
as a self -insurer.
27. Prepare, maintain and file all records and reports as may be required by legal authorities (State, local
and Federal.) Attach copies of reports.
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Request for Proposals (RFP) 207193,2
28. Prepare, maintain and file statistical or other records and reports as required by the Division of
Workers' Compensation.
29. Prepare, maintain and file statistical information required by Workers' Compensation Rating Bureaus,
including all required data necessary for the promulgation of experience modifications.
30. Review for accuracy and approve the appropriateness of state assessments, prior to the due date of the
assessment.
31. Establish an lmprest bank account to make claim, indemnity, expense and legal payments on checks
drawn from this account. It is understood that all funds in this account are City funds and shall be retumed
upon the City's request or the termination of the Contract. Regarding this account, the Administrator shall:
a) Reconcile on a monthly basis the account and provide all bank statements to the City monthly, along
with a request for a deposit from the City to maintain the balance needed in the account, as determined by
the City.
b) Ensure that any interest earned on the account is to go to reducing the subsequent monthly deposit by
the City.
c) Submit a monthly statement including the following:
d) balance at inception
e) total disbursements by date and claimant
f) balance at closing
g) amount of deposit required
h) list of all checks along with all statements supplied to the City
i) Bank account transactions and other information can additionally, or in lieu of, be provided by the
Successful Proposer to the City on-line or via other means for "real-time" access by the City.
32. Ensure that all adjusters handling City of Miami cases are kept abreast of the Workers' Compensation
Statutes, DWC rules, and applicable laws.
33. Ensure that the minimum standards of performance of its personnel conform to the Florida statutes and
administrative rules or future changes therein, if any.
34. Ensure all DWC filings, including compromise settlement agreement payments, are made in a correct
and timely manner.
35. Provide notification of suit being filed against the City for any reason, to the City Attomey's Office
and to Risk Management within twenty-four (24) hours.
36. Aggressively pursue recoveries to the satisfaction of the City, including recoveries based on
subrogation and special disability trust fund. The Administrator will pursue, track and provide quarterly
reports on all second injury fund.
37. Shall be responsible for data integrity. This includes properly inputting all cause codes, location codes,
loss descriptions, and other claims information. Ha data conversion is involved, the Administrator must
attest to the integrity of the combined data.
38. Obtain the approval of P_':-11 Management to hire experts in connection with claims against the'.��y.
Experts include, but are not limited to, rehabilitation vendors and private investigators.
39. Provide the means for the City to perform claims status inquiries.
40. Provide training for supervisory personnel of the City for those individuals responsible for workers'
compensation activities.
41. Comply with all applicable laws and regulations regarding the administration of Worker's
Compensation benefits.
42. Provide and integrate successfully an on-line claims management system that interfaces with all other
existing systems to be utilized in the performance of the scope reflected within this RFP.
43. Work closely with the Safety Manger to enhance Safety Program to reduce claims on an annual basis.
44. Assist in exploring the development of a Light Duty.Program for City employees.
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Request for Proposals (RFP) 207193,2
45. Shall provide to the City a performance guarantee, to be negotiated with the City in the provision of
Part 1 services as cited herein, to improve its effectiveness and efficiency while maximizing City resources.
B. HEARINGS / TRIALS
The Claims Administrator shall ensure that the following requirements for hearing conferences/trials are
followed:
1. Pre -hearing or pre-trial reports shall be submitted by the Claims Administrator to the City Attorney at
least two weeks prior to the hearing conference/trial or whenever requested by the City Attorney. Periodic
up -dates on ongoing litigation will be scheduled by the City Attorney as needed.
2. The reports must contain all information pertinent to the file including transcribed statements and
depositions.
3. The Claims Administrator shall obtain settlement authority from the City prior to any hearing
conference/trial.
4. Any recommendations made by the Claims Administrator pertaining to the file should be carried out
or referred to the City Attomey.
C. REPORTING REQUIREMENTS
1. Claims Administrator shall make an immediate report to the Risk Management Director or the
designee on:
a) fatalities; and
b) catastrophic occurrences with potential exposure of $50,000 or more
2. Submit "full captioned reports" within 30 days of setting reserve at or above S25,000. The content of
the "full captioned reports" shall include, but not be limited to, the following: coverage items, the
employee's background, (e.g., age, resident), dependents, employee's job description, occurrence, injury,
medical management, wage and compensation rates, dates and periods of disability, rehabilitation, other
employee benefits, litigation, index/state filings, subrogation, remarks and/or recommended actions, and
future strategy.
3. Submit "full -captioned report" on all files in litigation. Provide copies of all pleadings along with
the report.
4. Ensure that follow-up reports are received within 90 days of the "full -captioned report."
5. Submit monthly experience/statistical reports which shall include, but not be limited to, a summary
of experience by department stating cause of accident, frequency and cost. Open and closed claims shall
include specific information on the accident date, claimant's name, cause of accident, injury type, amount
paid and reserved, and state if the claim is open or has been finalized. These reports must be delivered by
the 10th of each month and must provide summary information by department, by participant, and by total
program.
6. Shall become familiar with existing labor contracts and report all activities pursuant to those
contracts to the Risk Management Director or the des:t nee as requested, at least on a monthly basis.
7. Shall provide the necessary reports and/or data to satisfy Florida's self-insurance requirements.
Required forms shall be completed by the Administrator and sent to the City for review and appropriate
signatures. Required self-insurance reports shall be provided on a timely basis so that the City will have
sufficient time to review and execute the documents before the due date.
D. "BAD FAITH" PROCEDURES
The following procedt res shall be followed to avoid potential actions for breach of good faiL%.snd fair
dealings:
1. Termination of Weekly Benefits: weekly benefits may be terminated only upon written or verbal
notification by the treating physician or the City when employee returns to work. If return to work
information is obtained verbally, the examiner must follow up in writing with a request for written
verification. If treating physician releases the employee to modified work, the Administrator must
promptly determine if modified work is available and offered to the employee before benefits
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Request for Proposals (RFP) 207193,2
are terminated.
2. Controverting Claims: the supervisors or examiner shall contact the City prior to formally denying a
claim. This will not be necessary when controverting the reasonableness and necessity of medical bills.
3. Judgments/Settlements: judgments/settlements should release potential future "bad faith" actions.
4. Penalties and Fines: penalties and fines assessed by the DWC shall be paid by the Administrator if
such fines and penalties result from negligent performances of its duties.
PART II SERVICESGENERAL, AUTOMOBILE, & PROFESSIONAL LIABILITY CLAIMS
ADMINISTRATION
A. Upon receipt of all liability claims, the Successful Proposer ("Claims Administrator"), on behalf of
the City, shall perform, at a minimum, the following services:
1. Review all first notices of claim reports received from the Ciry (which will consist of loss reports,
claim letters, suits or for claims that are phoned, mailed, or faxed in by the City), prior to an assignment to
an adjuster approved by the City.
2. The Claims Administrator will designate the necessary number of outside field adjusters to handle all
City claims and also designate an altemate in their absence. The designation of these persons is subject to
the approval of the City.
3. Conduct a thorough and complete investigation of the accident, according to the requirements of the
City.
4. Investigations are to include, but not be limited to, the following:
a) Contact the claimant or the claimant's attorney within 24 hours of the time the accident report is
received by the Successful Proposer. (In the case of underrepresented claimants, personal contact is
required the same day the claim is received). All claim files must contain adjuster's logs documenting all
contact and activity.
b) Obtain recorded statements from the claimant, witnesses, and the City personnel. Personal contact of
all underrepresented claimants by outside adjusters is required.
c) Complete a timely scene investigation consisting of photos and diagrams. This is required within 2
days of receipt of any serious AL or GL claim assignment.
d) Obtain the police and/or fire rescue report.
e) Obtain and review all medical reports and bills submitted by the claimant or their attorney.
f) Obtain and review all estimates and appraisals for property damage claims.
g) Establish appropriate reserves on all claims, and revise the reserves as needed.
h) Submit a report to the City within 30 days of receipt of the claim, summarizing:
i. Date/time/location of loss
ii. Claimant information
iii. Description of accident
iv. Injuries or damages
v. Witnesses' version
vi. Liability analysis
vii. Evaluation of claim (i.e. amount of recommended settlement, denial, reserves, attorney demand).
If a settlement recommendation cannot be made at this initial report (due to lack of information), indicate
same and reason. However, remainder of investigation should be completed.
i) Submit a status report every 90 days thereafter to the City until the claim is resolved.
The City prefers the above reporting requireinent to be accomplished via the on-line claims management
system for "real-time" viewing.
5. The Claims Administrator has the authority to settle cases on behalf of the City up to $10,000 per
claim for property damage and $3,000 for bodily injury.
6. For any settlement in excess of the above, the Claims Administrator must receive authorization from
the City. The request for this authorization must be presented in writing, including the adjuster's evaluation
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Request for Proposals (RFP) 207193,2
and recommendation in a format required by the City. After authorization is granted, the claims
administrator will settle the claim and obtain the appropriate release. The Claims Administrator will
advertise settlements as required by Florida Statute, Chapter 69. Additionally, the Claims Administrator
will provide a quarterly report to the City on all settlements above and below $10,000.
7. The City will assign an attorney for the legal defense of any claim that goes into suit. The claims
administrator will assist the City's attomeys with any additional investigations as deemed necessary by the
City or its attorney. The Claims Administrator will continue to monitor the file in litigation and control the
activities of defense counsel by requiring status reports every 90 days and directing the attomey's activities.
Claims Administrator will provide a monthly report of all litigated claims in the format specified by the
City.
8. Upon notification from the City, forward a copy of the file in suit to the City's selected attorney with
a transcription of all statements.
9. The Claims Administrator will attend all mediations and trials as requested by the City. With respect
to claims with impending trial dates, the Manager of the Claims Administrator will take an active and
aggressive role in settlement or preparation for trial.
10. The Claims Administrator, after approval of the City, can.assign the necessary auto appraiser for
property damage claims. These expenses will be paid as an allocated expense by the Claims Administrator
from the City's loss fund.
11. Any other claim expense must be approved by the City prior to being incurred. However, expenses for
normal claim activities, such as photographs, tapes, supplies, postage, etc. are the responsibility of the
Claims Administrator.
12. The Claims Administrator will meet monthly (or more frequently if required by the City) with the City
Manager and/or authorized representative to review all large exposure (over $25,000) incurred cases and
report on their status.
13. All claim files are at all times the property of the City. The City has the right to inspect any and all files
whenever we deem necessary. If the contract is terminated, the City will receive all original claim files.
14. The Claims Administrator will make recommendations to the City as to actions that can be taken to
prevent future claims. These loss prevention recommendations can be included in the status reports.
15. All work must be performed by the employees of the Successful Proposer. The use of any contracted or
independent adjuster is prohibited, unless prior approval is granted by the City.
16. The Claims Administrator will reimburse the City for payments made in error that are non -recoverable
from third parties by the Claims Administrator.
17. The Claims Administrator shall provide to the City a performance guarantee, to be negotiated with the
City in the provision of Part II services as cited herein, to improve its effectiveness and efficiency while
maximizing City resources.
The City desires prompt, personal contact of all claimants. Evaluations of each claim are to be made as
soon as the necessary information is received. The investigation and evaluation of all claims should be
completed prior to suit being filed, since F.S. 768.28 (sovereign immunity statute) requires the claimant
provide six months notice of intention to file suit.
At this time, there are 611 p'nding claims for liability. Refer to the information below for the numher of
claims and other pertinent-":-rla for the past three (3) years for General Liability, Automobile Lia'•_-`__y, and
Police Tort/Public Official Liability.
GENERAL LIABILITY
Year # of Claims Paid Reserves Total Incurred
10/1/2006 -9/30/2007 275 $227,852.38 $412,597.88 640,450.26
10/1/2007 - 9/30/2008 246 118,041.62 1,050,288.00 ,1,168,270.48
• 10/1/2008 - 9/30/2009 283 25,103.50 211,341.75 236,445.25
AUTOMOBILE LIABILITY
Year # of Claims Paid Reserves Total Incurred
10/1/2006 — 9/30/2007 335 $466,457.62 $122,443.53 588,901.15
10/1/2007 — 9/30/2008 376 465,657.70 351,833.57 817,491.27
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Request for Proposals (RFP) 207193,2
10/1/2008 — 9/30/2009 348 197,597.88 359,553.05 557,150.93
POLICE TORT
Year # of Claims Paid Reserves Total Incurred
10/1/2006 — 9/30/2007 33 $110,630.58 $970,757.14 $1,081,387.72
10/1/2007 — 9/30/2008 37 11,194.88 122,795.67 133,990.55
10/1/2008 — 9/30/2009 11 2,071.43 46,158.13 48,229.56
PUBLIC OFFICIAL LIABILITY
Year # of Claims Paid Reserves Total incurred
10/1/2006 — 9/30/2007 11
10/1/2007 — 9/30/2008 2
10/1/2008 — 9/30/2009 0
$267,794.86 $319,548.53
788.42 0.00
587,298.39
788.42
The Administrator must have up-to-date policy and procedure manuals on hand in the work place. These
manuals should describe and discuss the day to day procedures for adjusting files. The manuals should be
kept in accordance with statutory requirements. The Claims Administrator shall provide adequate toll -free
telephone access to the claims office.
The Claims Administrator shall provide Claims personnel, who shall be available on a 7 day, 24 hour basis
for investigating claims, and must have and maintain an 800 or toll -free number for emergency service. The
Claims Administrator must provide its own office space or facility(s) for its adjuster or staff of adjusters.
The Successful Proposer must agree to be responsible to manage liability claims to be opened within the
year(s) following contract execution, along with the current inventory of open files. The City is seeking a
Successful Proposer that will provide claims administration on a "life of relationship basis."
PART III SERVICES
MANAGED CARE SERVICES
Of the approximate 4,486 full-time employees, the following generally represents the location of their
Residences:
Miami -Dade County 3,869
Broward County 573
Collier County 7
Palm Beach County 31
St. Lucie County 6
Unknown 3 * zip codes do not appear in 4 counties listed
The number of new claims is approximately 550 per year. The ratio of medical only to loss time is 50%
Medical only, and 50% loss time.
Expenditures for the past two years are represented below:
Medicals paid:
Indemnity paid:
Expenses paid:
$4,626,969.35
1,172,184.22
70,067.31
A. The following represents the minimum required services to be provided to the City as required in this
RFP. The Successful Proposer:
1. Shall provide 24 hour toll free telephone number service for reporting worker injuries.
2. Shall. complete 4tatutory first report of injury (DWC1), injured worker inforrmation/g-it•vances and
medical provider services.
3. Shall channel injured workers to in -network and/or out -of -network providers approved by the City.
4. Shall manage the lost time element of claims.
5. Shall coordinate ancillary medical/disability management services.
6. Shall provide Preferred Provider Organization (PPO) networks access.
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Request for Proposals (RFP) 207193,2
7. Shall conduct Medical Utilization Review, Professional Peer Review, and provider appeal process.
8. Shall conduct Medical provider bill review and provider compliance.
9. Shall manage Out -of -network providers.
10. Shalt provide telephonic medical case management; vocational assessments, job site evaluations, and
other vocational services.
11. Shall provide mandatory reports, all State mandated reports, required tax information for the Internal
Revenue Service, including 1099 to the IRS, special administrative reports such as the OSEIA 200 and
others as determined by the City.
12. Shall effectively interface with the City's on-line claims management system or the TPA as part of
this RFP.
13. Shall prepare and submit the managed care application to the State of Florida with the assistance of
the City.
14. Successful Proposer will pay the providers' medical bills and interface with the Claims
Administrator's current and future system to ensure cost and effective processing of claims.
15. Shall provide to the City a performance guarantee, to be negotiated with the City in the provision of
Part III services as cited herein, to improve its effectiveness and efficiency while maximizing City
resources.
As discussed previously, the City's current Claims Administrator utilizes on-line claims processing system
where all data is maintained, updated, and payments are issued. The adjudication of Workers'
Compensation medical bills and payments to the City's providers are performed through this system. On a
monthly basis, the Claims Administrator provides the City with a bank reconciliation report to interface
with the City's financial system. The Successful Proposer shall be responsible for the provision of an
on-line claim processing system and the conversion of any data necessary for successful integration with
any and all other systems, including following the termination of the Contract. Any procedures, equipment,
and/or costs necessary to connect with the current Claims Administrator's hardware and software shall be
the sole responsibility of the Successful Proposer.
The Claims Administrator shall provide Claims personnel, who shall be available on a 7 day, 24 hour basis
for investigating claims, and must have and maintain an 800 or toll -free number for emergency service. The
Claims Administrator must provide its own office space or facility(s) for its adjuster or staff of adjusters.
The Successful Proposer must agree to be responsible for managed care claims to be opened within the
year(s) following contract execution, along with the current inventory of open files. The City is seeking a
Successful Proposer that will provide claims administration on a "life of relationship" basis.
3.3 STAFFING, QUALITY CONTROL AND SUPERVISION
A. Workers' Compensation and Liability
The Claims Administrator shall render high -quality claims management and adjusting services throughout
the entire Contract term. The personnel of the Claims Administrator should have, as a minimum, the
following levels of experience and licensing.
Si;.7rvisor or supervising adjuster 5-7 years
Adjusters 3 years
Medical -only processor(s) 1 year
A copy of each adjuster's and supervisor's Florida adjusting license must be made available prior to the
assignment of any claims.
Supervisors should receive all First Reports. of Injury and outline investigative needs for the adjusters to
follow through. Supervisors should assign,",h= most difficult files to the most qualified adjuster.
Successful Proposer shall perform monthly claims review with Risk Management to include the adjusters,
Risk Management and City Attorney.
It is the City's claims management philosophy that the proper and most cost-effective method to handle
claims and thereby reduce and control the City's self -insured loss payments is to ensure the claims
administrator hires and retains the appropriately.qualified professionals to handle the City's claims.
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Request for Proposals (RFP) 207193,2
Additionally, the adequate number of adjusters and a manageable caseload enables qualified adjusters to
perform the required services. The City therefore requires that the Successful Proposer agree to staffing,
qualifications, and caseload criteria established by the City.
The Cityreserves the right to the final prior approval of the hiring and/or assignment of the claims
manager, supervisors, and adjusters that are to handle the City's claims.
The Claims Administrator agrees to add staff as necessary to maintain these maximum pending caseload
levels. The proposer in its response must explain how its office or unit will be staffed, and the level of
supervision that will be provided.
Claims personnel must be employees of the Claims Administrator. The use of independent adjusters,
subcontractors, or temporary adjusters will not be acceptable without prior approval of the City. Adjuster
trainees are not acceptable for handling of the City's claims. The proposer must submit with its proposal the
resumes of all claims professionals specifically to be assigned to this account. All claims professionals
must possess a current Florida adjuster's license.
In addition to those services previously discussed, the Claims Administrator will additionally perform the
following related services:
1) State required filings.
2) Loss fund management
3) Computer generated loss runs and other management reports, preferably on-line
4) Provide an annual SAS 70 audit report.
The Claims Administrator shall have the ability to provide full service to English, Spanish, and
Haitian -Creole speaking individuals when needed.
The Claims Administrator shall make available to the City an individual with management authority to
meet with Risk Management Director or the designee upon reasonable notice. This individual shall have
the authority to make "agreed to changes." The Claims Administrator will meet Risk Management or the
designee on a quarterly or as -needed basis to discuss claims of interest. Sufficient advance notice will be
given to allow adequate preparation and data collection. The Claims Administrator's personnel, including
the adjuster or supervisor, must be available to attend Mediation conferences as necessary.
B. Managed Care Services
The Provider shall render high -quality claims management services throughout the entire Contract term.
The personnel of the Provider should have, as a minimum, the following levels of experience and licensing.
Supervisor 5-10 years
Nurse Case Manager 5-7 years
Account Representative: The Account Representative is fully qualified and responsible for the
performance of Provider's responsibilities under the Agreement. The Account Representative's
responsibilities include, but are not limited to:
Act as Provider's representative on any claims issue or problems.
Act as a liaison between City, medical network, City's designated Claims Administrator any` any other
parties as deemed neces.,4.y by the City.
Participate with and assist the Risk Management in the performance reviews, as required under the
Performance Agreement and review other claims as requested by the Risk Management under the
Agreement.
Files must reflect evidence of supervisory direction and involvement at every level. All files must be kept
current. File review should be performed on 30, 60, 90, 120 day cycles as appropriate. Periodic review by
the handling Nurse Case Manager and Supervisors shotld be rer�x;ted in the file.
Supervisors should receive all First Report of Injury and outline investigative needs for the Nurse Case
Manager to follow through. Supervisors should assign the most difficulty files to the most qualified Nurse
Case Manager.
Successful Proposer shall perform monthly claims review with Risk Management to include the adjusters,
Risk Management and City Attorney.
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Request for Proposals (RFP) 207193,2
It is the City's claims management philosophy that the proper and most cost-effective method to handle
claims and thereby reduce and control the City's self -insured loss payments is to ensure the claims
administrator hires and retains the appropriately qualified professionals to handle the City's claims.
Additionally, the adequate number of adjusters and a manageable caseload enables qualified adjusters to
perform the required services. The City therefore requires that the Successful Proposer agree to staffing,
qualifications, and caseload criteria established by the City.
The City reserves the right to the final prior approval of the hiring and/or assignment of the Nurse Case
Manager, supervisors to handle the City's claims.
The Provider agrees to add staff as necessary to maintain these maximum pending caseload levels. The
proposer in its response must explain how its office or unit will be staffed, and the level of supervision that
will be provided.
Claims personnel must be employees of the Provider. The use of Nurse Case Manager, subcontractors, or
temporary Nurse Case Manager will not be acceptable without prior approval of the City. The proposer
must submit with its proposal the resumes of all claims professionals specifically to be assigned to this
account. All claims professionals must possess a current Florida adjuster's license.
The Provider shall have the ability to provide full service to English, Spanish, and Haitian -Creole speaking
individuals when needed.
The Provider shall make available to the City an individual with management authority to meet with Risk
Management Director or the designee upon reasonable notice. This individual shall have the authority to
make "agreed to changes." The Provider will meet Risk Management or the designee on a quarterly or
as -needed basis to discuss claims of interest. Sufficient advance notice will be given to allow adequate
preparation and data collection. The Provider's personnel, including the Case Manager or supervisor, must
be available to attend Mediation conferences as necessary.
3.4 "BAD FAITH" LAWSUITS
The City shall be notified of all "bad faith" lawsuits which include breach of good faith and fair dealing.
Any "bad faith" lawsuits filed against the City or the Contract Administrator shall be handled by the City
of Miami's Law Department or its designee. If the allegation is that the Contract Administrator committed
or acted in "bad faith", the lawsuit and attorneys' fees and expenses shall be the Contract Administrator's
responsibility, but the City's Law Department will monitor the progress of the lawsuit to its conclusion. If
a claim is in litigation and there is also a "bad faith" claim alleged, it may be necessary to retain separate
attorneys. Once a "bad faith" lawsuit has been filed, a separate file pertaining only to the issues on "bad
faith" shall be established.
3.5 LOSS CONTROL SERVICES
When requested by the City to do so, the Contract Administrator shall consult with the City, its employees,
agents and others, concerning workplaces, operations, work procedures, and equipment owned or operated
by the City, and make recommendations to the City regarding same, for the purpose of establishing loss
control systems to mitigate and/or control losses, damage, and claims; provided, however, it is understood
and agreed that neither the rights of the Contract Administrator to make inspections, nor its
recommendations or reports as to loss control, s}tll constitute an undertaking on behalf of or for the benefit
of the City, or its employees or others, to deteri. ie, warrant, or guarantee that such work places,
operations, procedures, or equipment are free and safe from defects and/or hazards.
3.6 IRS FILING REQUIREMENTS OF CLAIMS ADMINISTRATOR
Contract Administrator will furnish required tax information for the Internal Revenue Service including
I099s with a copy of the 1 099s submitted to the IRS. Contract Administrator will prepare, maintain and
file all records andreports as may be required by legal authorities (State, local and Federal). Contract
Administrator wi'l,nrepare, maintain and file statistical information required by the Div.;sion of Workers'
Compensation and Rating Bureaus, including all data necessary for the promulgation of experience
modification, and as required by any other legal entity(s).
3.7 STATE REQUIRED FILINGS
At a minimum, the Claims Administrator shall be required to provide the following services:
A. Prepare and file, on behalf of the City, with the appropriate state agency, all applications required for
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Request for Proposals (RFP) 207193,2
the City's continued qualification as a self -insurer.
B. Prepare, maintain, and file all records and reports as may be required by legal State or Federal.
C. Prepare, maintain, and file statistical data, records, or reports as required by excess insurers, City
actuaries, and the State.
D. Prepare, maintain, and file statistical information required by worker's compensation rating bureaus,
including all data required for the promulgation of the City's experience modification and state assessment.
E. Prepare and file any other reports as required by the City and the State relating to claims experience,
payments, etc. (such as DWC-51, etc.)
3.8 LOSS FUND MANAGEMENT
A. The lmprest Account will be maintained at the City's commercial banking institution. The account
will be classified as part of the analysis group of the City's accounts. The City will pay all service fees that
are normal and customary in this account. All interest earned or service credits generated will accrue to the
benefit of the City.
B. The Claims Administrator is required to follow Florida law concerning public deposits. Specifically,
the Claims Administrator needs to follow F.S. 237.211(6) and F.S. 280' Security of Public Deposits. Failure
to comply with these laws is sufficient cause for the City to terminate the contractual agreement with the
Claims Administrator.
C. All claims, expense and legal payment will be made by the Claims Administrator on checks drawn on
an account set up by the Claims Administrator and funded monthly by the City. It is understood that all
funds in this account are City funds, and are to be returned to the City upon request or at termination of the
contract.
D. The Claims Administrator is responsible for the monthly reconciliation of this account and will
provide bank statements to the City monthly, along with a request for a deposit from the City to maintain
the monthly balance in the loss fund, as determined by the City.
E. The monthly reconciliation statement submitted by the Claims Administrator to the City shall, at
minimum, include the following:
1) Balance at inception of statement period
2) Total disbursements which cleared, by date and claimant/payee
3) Balance at close of statement period
4) Amount of deposit required.
F. A list of all checks is to be submitted on a monthly basis.
3.9 COMPUTER LOSS INFORMATION
All charges related to these services are to be included in the annual claims administration fee. Any costs
associated with programming changes that are necessary to create a report required by the City are the
responsibility of the claims administrator. In its proposal, Proposer should indicate any fees to be charged
for the creation of any special reports requested by the City, as necessary. All reports currently provided to
the City are required from the successful Claims Administrator.
uccessful Proposer(s) must ensure conductivity with the current syst•, . i and software used by Risk
ivlanagement and the Department of Finance, and all other involved uepartments. It must continue to
ensure, at its cost, that its system remains a viable solution for on-line claims administration should the City
upgrade or replace any aspect of its Risk and/or financial system throughout the term of the Contract.
All claims data is the property of the City and any data and media will be provided to the City upon
request and/or upon termination of the contract. All computer notes will be printed out and placed in the
files prior to file transfer to a successive Claims Administrator.
The successful Claims Administrator, ai its expense, will ensure all claims and payment data is included in
their loss runs by a date as determined by the City. Historical data from the current claims administrator's
database cannot be purged. Claims data for all open and closed claims must be transferred.
Loss runs are to be provided on a monthly basis (two copies), sorted separately by line of coverage (WC,
GL, AL), policy year, and department/location. Loss runs should list each claim separately. Specific
summary reports also must be provided. This requirement may be satisfied by utilizing the Successful
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Request for Proposals (RFP) 207193,2
Proposer's on-line system. The following reports, at a minimum, are required:
1) Claims list — lists all claims alphabetically
2) Check register
3) Cumulative report byline of coverage by year
4) Annual summary reports
5) Location report
6) Large loss or severity report
7) Safety report
8) Excess insurance report
9) Litigation report
10) Legal payments report
11). SAF 200 (OSHA log)
Workers compensation claims involving no payment or no medical treatment are reported by the City for
inclusion in the database as reporting purpose only (RPO) or first aid or no pay cases and should be
identified in the system that same way.
The Claims Administrator must provide the City the access via internet to the system for file review,
e-mail, or other purposes at no additional cost to the City. An 800 or other toll -free number is necessary for
on-line connections and faxes if the call is outside Miami -Dade County.
3.10 PROPOSED FEES
Proposer shall submit, separately, its proposed fees for the provision of Part 1 services, Part II services,
Part HI services, or a combination thereof.
For Part I, Workers Compensation Claims Administration Services: Part II General Automobile. and
Professional Liability Claims Administration• and Part III Managed Care Services:
Proposer shall submit a guaranteed, all-inclusive annual fee as previously detailed. This fee is to represent
all claims, administrative, and loss data fees.
For Part III Services, Managed Care Services, the City is interested in a program which will generate
savings over the current expenditures in the workers compensation area. The proposed fee structure should
address the mechanism for achieving a minimum of 15% net savings with an escalating incentive bonus for
savings that exceed the minimum and a penalty for a shortfall in the desire net savings.
Proposed rates are to be guaranteed annual fees for the first three (3) years, as opposed to per claim time
and expense or any other fee proposal: Proposals not containing an all inclusive guaranteed annual fee for
three (3) years for all specified services will not be considered. Clearly indicate any charge not included in
the proposed annual fee.
Other than the filing of applications for self-insurance, the Successful Proposer, at the option of the City,
shall be required to provide services on all claims occurring during the contract period and until six months
after the termination of+he contract (including renewals, extensions, or replacements thereof),,all legally
required reports for t1 ' intract period rendered, and all required reports to the Rating Buret-,Lir other
appropriate agencies made. The Successful Proposer's fee shall include the full consideration for such
continuing obligations, and except as noted herein, no additional consideration shall be due for such
obligations which extend beyond the contract period.
However, as part of its Proposal, and in order to determine pricing structure, Proposer shall also submit a
separate quote(s) for existing claims, and a separate quote(s) for prospective claims; pricing on a "per
claim" basis for both existing claims and prospective claims, and a breakdown of the cost between lost time
vs. medical. In addition, provide a per claim cost vs. fiat dollar.east. Include any other charges not included
in pricing.
Proposer shall provide prices in U.S dollars for the required services. It is important that Proposer outline
features of the Proposal, such as value-added product(s) and/or service(s) that would not normally be
addressed in a pricing evaluation as they are of a non -monetary nature. As such, Proposer should include
any relevant services or products that will be provided to the City which are not priced in its Proposal, but
which will enhance the acquisition process.
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Request for Proposals (RFP) 207193,2
As the Administrator may assume responsibility for the accurate and professional management of all open
claims previously administered by the City, Proposers shall review these claim files to determine the
additional cost, if any, to assume responsibility for these files. Financial data will be accurately merged in
the risk management information system so that loss -history information for prior periods will be
accurately included in the City's loss reports and for remote claims status inquiry. Proposer shall be
responsible for indicating in its Proposal the cost, if any, of assuming these prior claims and data
conversion and whether it is a one-time charge or an annual charge.
The current Claims Administrator utilizes an on-line claim processing system where all data is maintained,
updated and payments are issued. The Successful Proposer(s) must provide a similar mechanism as Risx
Facs Systems to provide the City with a bank reconciliation report to interface with the City's financial
information. The Successful Proposer(s) will include in its costs for the provision of an enhanced system
and for the conversion of any data necessary.
A Proposal must contain rates based on the "life of relationship basis," namely for those prospective
claims, and the City's inventory of open files. Proposer shall be responsible for all claims regardless of
day(s) or year(s) open, as the City will only pay a one- time charge at the time the files are opened. Provide
separate quotes for the assumption of prior claims and for prospective claims commencing on the
commencement date of the Contract.
The pursuit of subrogation and recovery from the Special Disability Fund is to be included in the
Administrator's annual fee.
The City will pay all legal defense fees, legal expenses, surveillance and any other claim related expenses
that are incurred in the proper handling of all claims that are not specifically outlined in this RFP.All such
expenses must have prior approval from Risk Management or the designee and of the City Attorney.
Normal operating expenses such as photos, copying, faxing, office supplies, postage, travel, etc. are to be
included in the annual fee and shall not be charged back to the City.
Some modifications of existing procedures, forms and contracts may be necessary to satisfy the City's
intent. It is understood that modifications may require a substantially greater fee than services without the
modifications, the amount of additional fee for the modifications must be disclosed in advance so the City
may exercise its option to purchase the modifications. It is preferred by the City that all desired
modifications be provided with little or no additional fee.
Proposers shall provide all costs related to the provision of all services per Part, as specified in this RFP. In
addition, Proposers shall provide in detail any other costs not foreseen, contemplated or considered by the
City at this time but which is regularly provided by Proposer.
Additional fee structures will be considered, in addition to the required fee structures, with preference
given to those which will generate significant savings to the City.
Proposed fees for the renewable option years, if applicable, must be submitted by the Successful
Proposer(s) to the City for consideration four (4) months in advance of each end of the Contract
year. The City reserves the right to accept, reject, and negotiate with Successful Proposer(s) any and
all fees proposed for each option year(s).
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Request for Proposals (RFP) 207193,2
4. Submission Requirements
4.1. SUBMISSION REQUIREMENTS
The following documentation shall be included as a minimum in the Proposal and submitted to the City.
Instructions to Proposers: Proposers should carefully follow the format and instructions outlined below,
observing format requirements where indicated. Proposals should contain the information itemized below
and in the order indicated. This information should be provided for the Proposer for the work contemplated
by this RFP. Proposals submitted which do not include the following items may be deemed non -responsive
and may not be considered for contract award.
ALL RESPONSES WILL BE SIJBMITTED IN HARD COPY FORMAT ONLY TO INCLUDE ONE
ORIGINAL AND FIVE (51 COPIES. NO ON-LINE SUBMITTALS WILL BE ACCEPTED.
The response to this solicitation should be presented in the following format. Failure to do so may deem
your Proposal non -responsive.
Should Proposer submit a Proposal to provide Part I Workers Compensation Claims Administration
Services; Part II General, Automobile, and Professional Liability Claims Administration; and/or
Part III Managed Care Services, Proposers must clearly indicate for which Part it is submitting its
Proposal and must provide all of the following for each Part proposed.
1. Cover Page
The Cover Page should include the Proposer's name; Contact Person for the RFP; Firm's Liaison for the
Contract; Primary Office Location; Local Business Address, if applicable; Business Phone and Fax
Numbers; Title of RFP; RFP Number; Federal Employer Identification Number or Social Security Number.
2. Table of Contents
The table of contents should outline, in sequential order, the major sections of the proposal as listed below,
including all other relevant documents requested for submission. All pages of the proposal, including the
enclosures, should be clearly and consecutively numbered and correspond to the table of contents.
3. Executive Summary:
A signed and dated summary of not more than two (2) pages containing the Proposer's Qualifications and
Experience, Ability to Perform Required Services, and Overall Approach and Methodology to Scope of
Work as contained in the submittal. Proposer must indicate for which Part(s) it is submitting a proposal.
Include the name of the organization, business phone and contact person. Provide a summary of the work to
be performed by Proposer.
The following information and documents are required to be provided with Proposer's response to this
RFP. Failure to do so may deem your Proposal non -responsive.
Part I: Workers Compensation Claims Administration Services
4. Proposer's Oualifications and Experience
a) Describe the Proposer's organizational history and structure; years Proposer and/or firm have been in
business providing a similar service(s), and indicate whether the City has previously awarded any contracts
to the Proposer/firm.
',) Provide a list of all principals, owners or directors.
c) Provide a complete list of all current Florida clients for which Proposer administers claims in a
Workers' compensation self-insurance or retention program. Include name, address, type of entity, type of
work done, phone number(s) and contact persons within each organization. Specifically identify clients for
whom a similar service has been provided, particularly to governmental entities similar in size to the City,
Trust, or other similar type as the City. Indicate whether Proposer assisted in disability, safety program,
light duty / return -to -work program, etc.
d) Provide a list of clients that have, for whatever reason, discontinued to use your services within the
past two (2) years, and indicate the reasons for the same. The City reserves the right to contact any
reference as part of the evaluation process.
e) Provide detailed background on the Project Manager and Claims Administrator to be assigned the
City's account throughout the duration of the Contract term, and whether Proposer agrees to City's terms
for approval of future Project Manager(s) / Claims Administrator should proposed representative leave
Proposer's firm during the Contract term. Provide copies of current applicable licenses for work to be
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Request for Proposals (RFP) 207193,2
performed in the State of Florida.
f) Provide two (2) Letters of Reference on letterhead from similar size governmental entities as the
City and for whom similar services have been performed. This information is subject to verification as part
of the evaluation process.
g) Provide letters of reference from law firms which currently handle your litigation. Provide contact
person and phone number for each.
5. Proposer's Ability to Perform Required Services
a) Describe the size of Proposer. Provide a complete list of all claims office locations and territory
serviced with Proposer's current personnel, indicating the number of personnel of Proposer and its ability to
provide required services to the City.
b) Describe where your main office is located and the location where the primary work will be performed.
Indicate location where the Project Manager / Claims Administrator will be located.
c) Discuss how its office or unit will be staffed, and the level of supervision that will be provided.
Discuss case assignments, including pending case load for each designated Adjuster and current number of
monthly new assignments to each Adjuster.
d) Discuss whether the award of this contract necessitates an increase in your staff size to meet the City's
staffing and caseload requirements, and whether staff will be in place by the start of the contract.
e) Provide a complete list of all licensed claim's personnel that will handle City's claims. Include a
resume of each Claims Administrator and / or Supervisor or Supervising Adjuster, Adjusters, Medical -only
processors, or other individuals including clerical and or support staff detailing education, experience in the
area of workers' compensation claims, and type of license(s). Include copies of all licenses held by each
individual, as all claims.professionals must possess a current Florida adjuster's license.
f) Explain the percentage of time your Adjusters are out of the office doing field work. If all are telephone
Adjusters, indicate as such. Explain whether you utilize independent contracted Adjusters, and under what
circumstances. Provide the name, address, phone, and contact person for independents you utilize.
g) Provide Copy of the most recently audited (or unaudited if audited not available) Financial Statement
of Proposer.
6. Overall Approach to Scope of Work
a) Discuss in detail Proposer's overall approach to the work to be performed.
b) Describe procedures and systems to be utilized. Include projected case loads per employee of
Proposer assigned to City account.
c) Provide a detailed timetable identifying significant milestones for the smooth transition of the
operations. Proposer shall identify the necessary support that shall be required from City staff during that
transition.
d) Provide a description of the standard loss reports, as well as provide a sample and descriptions of any
additional reports to be utilized.
e) Explain whether you currently file state and excess insurance forms on behalf of your clients and
attach copies of the forms used.
f) Describe Propos..'s methodology for evaluating and determining savings as expected;:,,thin this
RFP. Include in detail the mechanisms Proposer would use to track whether proposed savings goal has been
met, and methods to meet those goals. Indicate if willing to accept the incentive or penalty as indicated
should savings not result.
g) Detail any procedures, equipment, and/or costs necessary to connect with the City's hardware and
software, particularly related to conductivity with Risk and Finance, at the time of this RFP and should the
City's system be modified or replaced during the Contract term. Should there be associated costs; indicate
those costs, the reasons for the same, and who will pay those cns',s. Costs, if any, shall be detailed in the
Fee Proposal Section.
h) Explain any options which the Proposer's system has that will permit the City to generate reports
from, and to make direct inquiries into the Administrator's data base by on-line access. Proposer must
clearly identify in its Proposal the costs of providing any special conversion systems, license and software
costs for accessing the system, and the party(s) responsible for the payment of those costs, if any. (Costs
shall be fully detailed in Fee Proposal Section).
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Request for Proposals (RFP) 207193,2
i) If proposed, describe in detail Proposer's computerized on-line claims management system and
software to be utilized during the performance of the scope of work reflected herein. Detail functionality,
transition from current system, and if a cost is proposed, indicate in Proposer's Fee Proposal.
j) Provide sample reports describing information such as type of accident, accident site, department,
date and time, cause of accident, injury, and part of body. Proposer shall describe in detail any safety/loss
control reports that are provided by the system, and shall submit a listing of the variety of claims reports
available, and provide sample copies of formats that may be requested by the City.
k) Provide the methodology and list of allocated or anticipated expenses to employ outside
professionals such as surveillance, rehabilitation, experts, attorneys and others to assist in the investigation
and adjustment of claims.
7. Fee Proposal
a) Proposer shall submit a guaranteed, all-inclusive annual fee as previously detailed. This fee is to
represent all claims, administrative, and loss data fees. Proposed rates are to be guaranteed annual fees for
the first three (3) years, as opposed to per claim time and expense or any other fee proposal. Proposals not
containing an all inclusive guaranteed annual fee for three (3) years for all specified services, will not be
considered. The pursuit of subrogation and recovery from the.Special Disability Fund is to be included in
the Administrator's annual fee. Clearly indicate any charge not included in the proposed annual fee.
b) As part of its Proposal, and in order to determine pricing structure of an ensuring Contract, Proposer
shall also submit a separate quote(s) for existing claims, and a separate quote(s) for prospective claims;
pricing on a "per claim" basis for both existing claims and prospective claims, and a breakdown of the cost
between lost time vs. medical. In addition, provide a per claim cost vs. flat dollar cost. Include any other
charges not included in pricing.
c) Proposal must contain rates based on the "life of relationship basis," namely for those prospective
claims, and the City's inventory of open files. Proposer shall be responsible for al] claims regardless of
day(s) or year(s) open, as the City will only pay a one time charge at the time the files are opened. Provide
separate quotes for the assumption of prior claims and for prospective claims commencing on the
commencement date of the Contract.
d) Proposer shall provide prices in U.S dollars for the required services. It is important that Proposer
outline features of the Proposal, such as value-added product(s) and/or service(s) that would not normally
be addressed in a pricing evaluation as they are of a non -monetary nature. As such, Proposer should include
any relevant services or products that will be provided to the City which are not priced in its Proposal, but
which will enhance the acquisition process.
e) Proposer shall be responsible for indicating in its Proposal the cost, if any, of assuming these prior
claims and data conversion and whether it is a one-time charge or an annual charge. As the current TPA
utilizes an on-line claim processing system where all data is maintained, updated and payments are issued,
the Successful Proposer(s) must provide a similar mechanism as Risx-Facs to provide the City with a bank
reconciliation tape and a tape to interface with the City's financial information. The Successful Proposer(s)
will include in its costs for the provision of an enhanced system and for the conversion of any data
necessary.
f) Proposed performance guarantee, to be negotiated with the City.
g) Provide any and all additional costs, item by item, as identified by Proposer in any other area not
previously discussed and detail what those ^-;e,.itional costs, if applicable, would entail. Include which entity
(Proposer or City) that will be responsible for payment of those costs.
8. Local Preference. if applicable
a) State the Primary Office Location of the Proposer.
b) Provide location from which the Proposer will be based to perform the work.
Part II: Geiaeral, Automobile, and Professional Liability Claims Adniinistratiun
4. Proposer's Qualifications and Experience
a) Describe the Proposer's organizational history and structure; years Proposer and/or firm have been in
business providing a similar service(s), and indicate whether the City has previously awarded any contracts
to the Proposer/fine.
b) Provide a list of all principals, owners or directors.
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Request for Proposals (RFP) 207193,2
c) Provide a complete list of all current Florida clients for which Proposer administers general and
automobile liability claims. Include name, address, type of entity, type of work done, phone number(s) and
contact persons within each organization. Specifically identify clients for whom a similar service has been
provided, particularly to governmental entities similar in size to the City, Trust, or other similar type as the
City.
d) Discuss in detail Proposer's qualifications and experience to provide general liability and automobile
Iiability claims administration. Include the Proposer's thorough knowledge of all State Statutes and other
applicable laws governing this RFP to show a complete understanding of the work to be performed.
e) Provide a list of clients that have, for whatever reason, discontinued to use your services within the
past two (2) years, and indicate the reasons for the same. The City reserves the right to contact any
reference as part of the evaluation process.
f) Provide detailed background on the Project Manager and Claims Administrator to be assigned the
City's account throughout the duration of the Contract term, and whether Proposer agrees to City's terms
for approval of future Project Manager(s) / Claims Administrator should proposed representative leave
Proposer's firm during the Contract term. Provide copies of current applicable licenses for work to be
performed in the State of Florida.
g) Provide two (2) Letters of Reference on letterhead from similar size governmental entities as the City
and for whom similar services have been performed. This information is subject to verification as part of
the evaluation process.
h) Provide letters of reference from law firms which currently handle your litigation. Provide contact
person and phone number for each.
5. Proposer's Ability to Perform Required Services
a) Provide a general description of the firm, including its size, approximate number of personnel, and
the areas of coverage. Provide a complete list of all claims office locations and territory serviced with
Proposer's current personnel, indicating the number of personnel of Proposer and its ability to provide
required services to the City.
b) Describe where your main office is located and the location where the primary work will be
performed. Indicate location where the Project Manager / Claims Administrator will be located.
c) Discuss how its office or unit will be staffed, and the level of supervision that will be provided.
Discussed case assignments, including pending case load for each designated Adjuster and current number
of monthly new assignments to each Adjuster.
d) Discuss whether the award of this contract necessitates an increase in your staff size to meet the
City's staffing and caseload requirements, and whether staff will be in place by the start of the contract.
e) Provide a complete list of all licensed claim's personnel that will handle City's claims. Include a
resume of each Claims Administrator and / or Supervisor or Supervising Adjuster, Adjusters, or other
individuals including clerical and or support staff detailing education, experience in the area of liability
claims, and type of license(s). Provide copies of all licenses held by each individual, as all claims
professionals must possess a current Florida adjuster's license.
6. Overall Approach to Scope of Work
, a) Discuss in detail Proposer's overall approach to the work to b;,, ierformed.
b) Describe procedures and systems to be utilized. Include projected case loads per employee or
Proposer assigned to City account.
c) Provide a detailed timetable identifying significant milestones for the smooth transition of the
operations. Proposer shall identify the necessary support that shall be required from City staff during that
transition.
d) Provide a description of the standard reports, as well as provide a sample and descriptions of any
additional reports to be utilized.
e) Explain whether you currently file state and excess insurance forms on behalf of your clients and
attach copies of the forms used.
f) If proposed, describe in detail Proposer's computerized on-line claims management system and
software to be utilized during the performance of the scope of work reflected herein. Detail functionality,
transition from current system, and if a cost is proposed, indicate in Proposer's Fee Proposal.
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Request for Proposals (RFP) 207193,2
g) Explain any options which the Proposer's system has that will permit the City to generate reports
from, and to make direct inquiries into the Administrator's data base by on-line access. Proposer must
clearly identify in its Proposal the costs of providing any special conversion systems, license and software
costs for accessing the system, and the party(s) responsible for the payment of those costs, if any. (Costs
shall be fully detailed in Fee Proposal Section).
h) Provide sample reports describing information such as type of accident, accident site, department,
date and time, cause of accident, injury, and part of body. Proposer shall describe in detail any safety/loss
control reports that are provided by the system, and shall submit a listing of the variety of claims reports
available, and provide sample copies of formats that may be requested by the City.
i) Provide the methodology and list of allocated or anticipated expenses to employ outside
professionals such as surveillance, experts and attorneys to assist in the investigation and adjustment of
claims.
7. Fee Proposal
a) Proposer shall submit a guaranteed, all-inclusive annual fee as previously detailed. This fee is to
represent all claims, administrative, and loss data fees. Proposed rates are to be guaranteed annual fees for
the first three (3) years, as opposed to per claim time and expense or any other fee proposal. Proposals not
containing an all inclusive guaranteed annual fee for three (3) years for all specified services, will not be
considered. Clearly indicate any charge not included in the proposed annual fee.
b) As part of its Proposal, and in order to determine pricing structure of an ensuring Contract, Proposer
shall also submit a separate quote(s) for existing claims, and a separate quote(s) for prospective claims;
pricing on a "per claim" basis for both existing claims and prospective claims, and a breakdown of the cost
between lost time vs. medical. In addition, provide a per claim cost vs. flat dollar cost, Include any other
charges not included in pricing.
c) Proposal must contain rates based on the "life of relationship basis," namely for those prospective
claims, and the City's inventory of open files. Proposer shall be responsible for all claims regardless of
day(s) or year(s) open, as the City will only pay a one time charge at the time the files are opened. Provide
separate quotes for the assumption of prior claims and for prospective claims commencing on the
commencement date of the Contract.
d) Proposer shall provide prices in U.S dollars for the required services. It is important that Proposer
outline features of the Proposal, such as value-added product(s) and/or service(s) that would not normally
be addressed in a pricing evaluation as they are of a non -monetary nature. As such, Proposer should include
any relevant services or products what will be provided to the City which are not priced in its Proposal, but
which will enhance the acquisition process.
e) Proposer shall be responsible for indicating in its Proposal the cost, if any, of assuming these prior
claims and data conversion and whether it is a one-time charge or an annual charge. As current TPA
utilizes an on-line claim processing system where all data is maintained, updated and payments are issued.
The Successful Proposer(s) must provide a similar mechanism as Risx-Facs to provide the City with a bank
reconciliation tape and a tape to interface with the City's financial information. The Successful Proposer(s)
will include in its costs for the provision of an enhanced system and for the conversion of any data
necessary.
f) Proposed performance guarantee, to be negotiated with the City.
g) Provide any' .::1 all additional costs, item by item, as identified by Proposer in any ':er area not
previously discussed and detail what those additional costs, if applicable, would entail. Include which entity
(Proposer or City) that will be responsible for payment of those costs.
8. Local Preference. if applicable
a) State the Primary Office Location of the Proposer.
b) Provide location from which the Proposer will be based to perform the work.
Part III: Managed Care Services
4. Jroposer's Qualifications and Experience
a) Describe the Proposer's organizational history and structure; years Proposer and/or firm have been in
business providing a similar service(s), and indicate whether the City has previously awarded any contracts
to the Proposer/firm.
b) Provide a list of all principals, owners or directors.
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Request for Proposals (RFP) 207193,2
c) Provide a complete list of all current Florida clients for which Proposer administers managed care
services. Include name, address, type of entity, type of work done, phone number(s) and contact persons
within each organization. Specifically identify clients for whom a similar service has been provided,
particularly to governmental entities similar in size to the City, Trust, or other similar type as the City.
d) Discuss in detail Proposer's qualifications and experience to provide managed care services. Include
the Proposer's thorough knowledge of all State Statutes and other applicable laws goveming this RFP to
show a complete understanding of the work to be performed.
e) Provide a list of clients that have, for whatever reason, discontinued to use your services within the
past two (2) years, and indicate the reasons for the same. The City reserves the right to contact any
reference as part of the evaluation process.
f) Provide detailed background on the Account Representative/Project Manager and Claims
Administrator to be assigned the City's account throughout the duration of the Contract term, and whether
Proposer agrees to City's terms for approval of future Project Manager(s) / Claims Administrator should
proposed representative leave Proposer's firm during the Contract term. Provide copies of current
applicable licenses for work to be performed in the State of Florida.
g) Provide two (2) Letters of Reference on letterhead from similar size governmental entities as the City
and for whom similar services have been performed. This information is subject to verification as part of
the evaluation process.
5. Proposer's Ability to Perform Required Services
a) Describe the size of Proposer. Provide a complete list of all claims office locations and territory
serviced with Proposer's current personnel, indicating the number of personnel of Proposer and its ability to
provide required services to the City.
b) Describe where your main office is located the location where the primary work will be performed.
Indicate location where the Project Manager/Claims Administrator will be located.
c) Discuss how its office or unit will be staffed, and the level of supervision that will be provided.
Discuss case assignments, including pending case load for each designated nurse case manager and current
number of monthly new assignments to each nurse case manager.
d) Discuss whether the award of this contract necessitates an increase in your staff size to meet the
City's staffing and caseload requirements, and whether staff will be in place by the start of the contract.
e) Provide a complete list of all licensed claim's personnel that will handle the City's managed care
services. Include a resume of each Supervisor or Supervising nurse case manager, case manager,
Medical -only processors, or other individuals including clerical and or support staff detailing education,
experience in the area of managed care, and type of license(s). Include copies of all licenses held by each
individual.
f) Provide a general description of the firm, including its size, approximate number of personnel, and
the areas of coverage. Include how Proposer will ensure managed care services by City employees residing
in Miami -Dade, Broward, Palm Beach, and Monroe Counties, among other locales.
g) Provide copy of the most recent recently audited (or unaudited if audited not available) Financial
Statement of Proposer.
6. Overall Approach to Scope of Welk
a) Discuss in detail Proposer's overall approach to the work to be performed.
b) Describe procedures and systems to be utilized. Include projected case loads per employee of
Proposer assigned to the City's account.
c) Discuss in detail exactly how all services reflected in the Scope of Work will be accomplished. All
items (#1-#15) should be individually addressed. Include a complete approach Proposer will take to meet
all responsibilities expected of Proposer by the City. Include any and all information regarding affiliated
physicians, ether medical personnel, locations to provide said services, and other rrk led information
regarding the provision of such services for the City.
d) Provide detailed timetable identifying significant milestones for the smooth transition of operations.
Proposer shall identify the necessary support that shall be required from City staff during that transition.
e) Provide a description of the standard loss reports, as well as provide a sample and descriptions of any
additional reports to be utilized.
f) Detail any procedures, equipment, and/or costs necessary to connect with the City's hardware
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Request for Proposals (RFP) 207193,2
software. Should there be associated costs, indicate those costs, the reasons for the same, and who will pay
those costs. Costs, if any, shall be detailed in the Fee Proposal Section.
g) If proposed, described in detail Proposer's computerized on-line claims management system and
software to be utilized during the performance of the scope of work reflected herein. Detail functionality,
transition from current system, and if a cost is proposed, indicate the Proposer's Fee Proposal.
h) Explain any options which the Proposer's system has that will permit the City to generate reports
from, and to make direct inquires into the Administrator's data base on on-line access.
i) Provide sample reports describing information such as type of accident, accident site, department,
date and time, cause of accident, injury, and part of body. Proposer shall describe in detail any safety/loss
control reports that are provided by the system, and shall submit a listing of the variety of claims reports
available, and provide sample copies of formats that may be requested by the City.
j) Provide the methodology and list of allocated or anticipated expenses to employ outside
professionals such as surveillance, rehabilitation, experts, attorneys, etc. to assist.
7. Fee Proposal
a) AstheCity is interested in a program which will generate savings over the current expenditures in the
workers' compensation area, the proposed fee structure should address the mechanism for achieving a
minimum of 15% net savings with an escalating incentive bonus for savings that exceed the minimum and
a penalty for a shortfall in the desire net savings.
b) Proposed rates are to be guaranteed annual fees for the first three (3) years, as opposed to per claim
time and expense or any other fee proposal. Proposals not containing an all inclusive guaranteed annual fee
for three (3) years for all specified services, will not be considered. Clearly indicate any charge not
included in the proposed annual fee.
c) Proposer shall also submit a separate quote(s) for existing claims, and a separate quote(s) for
prospective claims; pricing on a "per claim" basis for both existing claims and prospective claims, and a
breakdown of the cost between lost time vs. medical. In addition, provide a per claim cost vs. flat dollar
cost. Include any other charges not included in pricing.
8. Local Preference. if applicable
a) State the Primary Office Location of the Proposer.
b) Provide location from which the Proposer will be based to perform the work.
9. Trade Secrets Execution to Public Records Disclosure
All Proposals submitted to the City are subject to public disclosure pursuant to Chapter 119, Florida
Statutes. An exception may be made for "trade secrets."
If the Proposal contains information that constitutes a "trade secret", all material that qualifies for
exemption from Chapter 119 must be submitted in a separate envelope, clearly identified as "TRADE
SECRETS EXCEPTION," with your ftrm's name and the RFP number marked on the outside.
Please be aware that the designation of an item as a trade secret by you may be challenged in court by any
person. By your designation of material in your Proposal as a "trade secret" you agree to indemnify and
hold harmless the City for any award to a plaintiff for damages, costs or attorney's fees and for costs and
attorney's fees incurred by the City by reason of any legal action challenging your claim.
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Request for Proposals (RFP) 207193,2
5. Evaluation Criteria
5.1. EVALUATION CRITERIA
Proposals shall be evaluated based upon the following criteria and weight:
CRITERIA PERCENTAGE
Proposer's Qualifications and Experience 20
Proposer's Ability to Perform Required Services 20
Methodology and Overall Approach to Scope of Services 25
Fee Proposal 25
Local Preference, if applicable 10
Total: 100
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