Census Spreadsheet (003) (2).xls

XLS spreadsheet 47 KB Posted

Attached to
19GE5024R0086 - Health Insurance Services - Kyiv, Ukraine
Solicitation number
19GE5024R0086
Issued by

About this file

This document appears to be an Excel spreadsheet containing a list of census information for International Policyholders, including their name, gender, date of birth, citizenship, U.S. zip code, work location, coverage type, country where dependents reside, occupation, annual salary, and U.S. visa type.

The related federal contract opportunity is Solicitation Number 19GE5024R0086 for "Health Insurance Services - Kyiv, Ukraine". The U.S. Government requires health insurance for its Locally Employed Staff (LES) and their dependents at the U.S. Embassy in Kyiv, Ukraine. The contractor shall provide the health insurance services in accordance with the Statement of Work (SOW) and attached solicitation documents. The solicitation is issued by the Department of State Office of Acquisition Management.

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Text version

International Census

Policyholder Name:
U.S. Address:
Effective Date:
Required Information for All Quote RequestsRequired for Life, AD&D and LTD QuotesRequired if Work Location is United States
No.NameGenderDate of BirthCitizenshipU.S. Zip Code for US Citizens and InpatsWork LocationCoverage TypeCountry Where Dependents ResideOccupationAnnual SalaryU.S. Visa Type
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Provide coverage tiering: Employee Only, Employee + Spouse, etc.

Sheet1

File details come from the government source that posted it. Updated .