2026_RFP_PC_Broker-_Cost_Quotation_Page--EXHIBIT_B.pdf

EXHIBIT B

PROPOSAL FORM

INSURANCE BROKERAGE SERVICES

PROPERTY & CASUALITY INSURANCE

COST QUOTATION

INSTRUCTIONS: Indicate below the proposed annual compensation for providing Insurance brokerage services (Scope of Services, EXHIBIT A) during the three-year service period (and three-year renewal if option exercised by the CITY). Actual annual compensation should be the same as proposed compensation unless “Scope of Services” is changed at the request of the City of Daytona Beach.

Scope of Services (including EXHIBIT A) must continue to be provided annually during the period of the Agreement between the City of Daytona Beach and Broker at the flat annual fee.

This annual compensation shall be in an agreed amount not subject to any commission from insurance companies or reimbursement for travel or other out-of-pocket expenses.

A. Property & Excess Casualty Insurance

(Broker must provide a quote for Broker services for all coverages in the scope of services;

partial quotes will not be considered) The annual professional fee is for all costs, fees, charges associated with the broker services rendered as outlined in the scope of services.

Any commission payments that the selected broker receives in connection with the procurement of insurance coverage for the City pursuant to these services will be credited against the fees owed under this contract unless said commission is exempt as stated in Section IV. If a policy cannot be written net of commission, the broker shall identify the policy from the City’s list of existing insurance in Exhibit A and give reasons why. The compensation for procuring policies that cannot be written net of commission shall be omitted from the Total Annual Broker Service Fee quoted below as the broker’s compensation will be the commission for obtaining said policies.

Insurance premiums should not be included in the broker services fees below.

Total Annual Broker Service Fee $__________________

The Broker is allowed commission on any newly placed policies obtained by the broker at the City’s request during the contract period that is not included in the current insurance list in Exhibit A.

The undersigned person by his/her signature affixed hereon warrants that:

A. He/she is an officer or a partner of the respondent, or the respondent is a sole proprietor, and the enclosed proposal is submitted on behalf of the respondent, and

B. The respondent authorizes the contact of any references provided in the proposal and specifically authorizes such references to release either orally, or in writing, any appropriate date with respect to the respondent offering this proposal, and

C. The selected broker will submit invoices quarterly (in arrears) based on the agreed annual broker service fee, and

D. He/she has carefully reviewed all the material and data provided on the respondent’s proposal on behalf of the respondent, including attachments A & B, and after specific inquiry, believes all the material and data to be true and correct.

The respondent will agree to all terms of the contract except as follows:

Name of Respondent

Signature of Authorized Representative

Name of Authorized Representative (printed)

Title (printed)

Date

COST QUOTATION