25_123_RFP.pdf

RFP #25-123 Third Party Administrative Services for Workers Compensation RFP Due: Monday, December 30, 2024 @ 1:00 p.m.

Request for Proposals

RFP Item #25-123

Third Party Administrative Services for Workers Compensation

For Augusta, Georgia - Finance Department

Until further notice All RFP openings, conferences, and evaluation meetings will be conducted by electronic teleconferencing via ZOOM.

Instructions are enclosed.

Sec. 1-10-50. Sealed bids selection method:

Bid acceptance and bid evaluation. Provided that the bids are delivered to the Procurement Director at the time, place, and under the conditions contained in the Invitation for Bids, the bids shall be conditionally accepted without alteration or correction pending evaluation.

To Ensure Timely Deliveries, It Is The Responsibility Of The Vendor To Ensure Their Bid Submittal Is Received By The Time Specified Above. All Submittals MUST Be Received During Our Normal Office Hours From 8:30 A.M. To

5:00 P.M., Monday Through Friday. No Deliveries Will Be Accepted Prior To 8:30 A.M. Or After 5:00 P.M., As The Building Is Closed To The Public And Delivery Services Outside Of These Hours.

One Original and Seven (7) Copies of RFP shall be submitted

Thanks for doing business with us . . .

Darrell White, Interim Procurement Director

535 Telfair Street, Room 605 Augusta, Georgia 30901

Rev. 10/02/2024

Table of Contents

Request for Proposal

Instructions to Submit

Purpose Viewing of the Augusta Code

Compliance with Laws Proposal for All or Part Minority/Women Business Enterprise (MWBE) Policy Augusta Georgia License Requirement Terms of Contract

Notice to All Proponents Required to be returned with your submittal. Both documents must be notarized

Attachment B Must return the 2 pages Systematic Alien Verification for Entitlements (SAVE) Program

Minority and Women Owned Business Enterprise Program Ordinance Requirements

Request for Proposal Specifications

Revised 9/6/24

Request for Proposals

Request for Proposals will be received at this office until Monday, December 30, 2024 @ 1:00 p.m. via ZOOM Meeting ID: 846 7480 7796; Passcode: 25123 for furnishing:

RFP Item #25-123 Third Party Administrative Services for Workers Compensation for Augusta, GA – Finance Department

RFPs will be received by: The Augusta Commission hereinafter referred to as the OWNER at the offices of:

Darrell White, Interim Director Augusta Procurement Department 535 Telfair Street - Room 605

RFP documents may be viewed on the Augusta Georgia web site under the Procurement Department ARCbid. RFP documents may be obtained at the office of the Augusta, GA Procurement Department, 535 Telfair Street – Room 605, Augusta, GA 30901 (706- 821-2422).

All questions must be submitted in writing by fax to 706 821-2811 or by email to procbidandcontract@augustaga.gov to the office of the Procurement Department by Friday, December 13, 2024 @ 5:00 P.M. No RFP will be accepted by fax or email, all must be received by mail or hand delivered. To ensure timely deliveries, all submittals must be received during our normal office hours from 8:30 a.m. to 5:00 p.m., Monday through Friday. No deliveries will be accepted prior to 8:30 a.m. or after 5:00 p.m., as the building is closed to the public and delivery services outside of these hours.

No RFP may be withdrawn for a period of 90 days after RFPs have been opened, pending the execution of contract with the successful bidder(s).

Request for proposals (RFP) and specifications. An RFP shall be issued by the Procurement Office and shall include specifications prepared in accordance with Article 4 (Product Specifications), and all contractual terms and conditions applicable to the procurement. All specific requirements contained in the request for proposal including, but not limited to, the number of copies needed, the timing of the submission, the required financial data, and any other requirements designated by the Procurement Department are considered material conditions of the bid which are not waivable or modifiable by the Procurement Director. All requests to waive or modify any such material condition shall be submitted through the Procurement Director to the appropriate committee of the Augusta, Georgia Commission for approval by the Augusta, Georgia Commission. Please mark RFP number on the outside of the envelope.

GEORGIA E-Verify and Public Contracts: The Georgia E-Verify law requires contractors and all sub-contractors on Georgia public contract (contracts with a government agency) for the physical performance of services over $2,499 in value to enroll in E-Verify, regardless of the number of employees. They may be exempt from this requirement if they have no employees and do not plan to hire employees for the purpose of completing any part of the public contract. Certain professions are also exempt. All requests for proposals issued by a city must include the contractor affidavit as part of the requirement for their bid to be considered.

Proponents are cautioned that acquisition of RFP documents through any source other than the office of the Procurement Department is not advisable. Acquisition of RFP documents from unauthorized sources places the proponent at the risk of receiving incomplete or inaccurate information upon which to base their qualifications.

Correspondence must be submitted via mail, fax or email as follows:

Augusta Procurement Department Attn: Darrell White, Interim Director of Procurement 535 Telfair Street, Room 605 Augusta, GA 30901 Fax: 706-821-2811 or Email: procbidandcontract@augustaga.gov

DARRELL WHITE, Interim Procurement Director

Publish:

Augusta Chronicle November 21, 29, 2024 and December 5, 12, 2024 Metro Courier November 21, 2024 cc Tameka Allen Administrator Timothy Schroer Finance Department Judy Blackstone Finance Department

Revised: 10/02/24 mailto:procbidandcontract@augustaga.gov http://gma.informz.net/z/cjUucD9taT0yMjUwOTU1JnA9MSZ1PTUxODY3MTg3MiZsaT0yMTQ3NjI3Nw/index.html

PROCUREMENT DEPARTMENT

ELECTRONIC ZOOM INFORMATION

The Augusta, Georgia Procurement Department conducts Public RFP Pre-Proposal Conferences and Openings to award quality contracts for Augusta. Proposers may participate in our Public RFP Pre-Proposal Conferences and Openings via webcast or teleconference by following the instructions outlined below:

ELECTRONIC RFP INSTRUCTIONS

Join from a PC, Mac, iPad, iPhone, or Android device

RFP Opening - RFP Item #25-123

Third Party Administrative Services for Workers Compensation for Augusta, GA - Finance Department

Monday, December 30, 2024 @ 1:00 p.m.

ZOOM RFP Opening:

1. Go to https://zoom.us/join and enter meeting ID: 846 7480 7796

2. Passcode: 25123

3. Teleconference: Telephone number: 646 876 9923

OFFICIAL RFP RESULTS will Post within 5 Days

For Assistance: Please Contact the Bid and Contract Team at (706) 821-2422 https://zoom.us/join https://zoom.us/join

INSTRUCTIONS TO SUBMIT

INSTRUCTIONS TO SUBMIT

1.1 Purpose: The purpose of this document is to

provide general and specific information for use by vendors in submitting a proposal to supply Augusta, Georgia with equipment, supplies, and or services as listed above. All proposals are governed by the Augusta, Georgia Code.

1.2 Viewing the Augusta Code: All proposals are

governed and awarded in accordance with the applicable federal and state regulations and the Augusta, Georgia Code. To view the Code visit Augusta’s website at www.augustaga.gov or http://www.augustaga.gov/index.aspx?NID=68 5 Guidelines & Procedures.

1.3 Compliance with laws: The Proponent shall

obtain and maintain all licenses, permits, liability insurance, workman's compensation insurance and comply with any and all other standards or regulations required by federal, state or Augusta, Georgia statute, ordinances and rules during the performance of any contract between the Proponent and Augusta, Georgia. Any such requirement specifically set forth in any contract document between the Proponent and Augusta, Georgia shall be supplementary to this section and not in substitution thereof.

1.4 Proposal’s For All Or Part: Unless otherwise

specified by Augusta, Georgia or by the proponent, AUGUSTA, GEORGIA RESERVES THE

RIGHT TO MAKE AWARD ON ALL ITEMS, OR ON

ANY OF THE ITEMS ACCORDING TO THE BEST

INTEREST OF AUGUSTA, GEORGIA. Proponent may restrict his proposal to consideration in the aggregate by so stating but must name a unit price on each item submitted upon.

1.5 All protest shall be made in writing to:

Attn: Darrell White, Interim Director of Procurement 535 Telfair Street, Room 605 Augusta, GA 30901, Fax: 706-821-2811 or Email: procbidandcontract@augustaga.gov

Revised 10/02/2024

1.6 Minority/Women Business Enterprise (MWBE)

Policy: Court Order Enjoining Race-Based Portion of DBE Program Augusta, Georgia does not have a race or gender conscious Disadvantaged Business Enterprises (DBE) program for projects having Augusta, Georgia as the source of funding. Augusta does enforce mandatory DBE requirements of federal and state agencies on contracts funded by such agencies and has a DBE Program to comply with U.S. Department of Transportation (DOT), Federal Transit Administration (FTA), Federal Aviation Administration (FAA) and other federal and state mandated DBE requirements for certain DOT, FTA, FAA, and other federal and state assisted contracts as required by 49 C.F.R. Part 26, et. seq. and/or 49 C.F.R. Part 23, et. seq. This DBE program is only for DOT, FTA and FAA assisted contracts and other federal or state funded contracts having mandatory DBE requirements. (See Article 13 of the Augusta, GA.

Code.)

Augusta, Georgia prohibits any language in any solicitation, bid or contract that is inconsistent with the July 21, 2011, Court Order in the case, Thompson Wrecking, Inc. v. Augusta Georgia, civil action No. 1:07-CV-019. Any such language appearing in any Augusta, Georgia solicitation, bid or contract is void and unenforceable.

A copy of this Order can be reviewed at www.augustaga.gov home page.

1.7 Augusta, Georgia License Requirement: For

further information contact the License and Inspection Department @ 706 312-5050.

General Contractors License Number: If applicable, in accordance with O.C.G.A. §43-41, or be subjected to penalties as may be required by law.

Utility Contractor License Number: If applicable, in accordance with O.C.G.A. §43-14, or be subjected to penalties as may be required by law.

1.8 Terms of Contract: (Check where

applicable)

[ ] (A) Annual Contract [ ] (B) One time Purchase.

[X] (C) Other file://///augunity01/procurementcommon/th13290/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/2015%20Bid%20Information/15-172A%20Temporary%20Staffing%20Services/www.augustaga.gov http://www.augustaga.gov/index.aspx?NID=685%20%20Guidelines%20&%20Procedures http://www.augustaga.gov/index.aspx?NID=685%20%20Guidelines%20&%20Procedures http://www.augustaga.gov/

NOTICE TO ALL VENDORS

ADHERE TO THE BELOW INSTRUCTIONS AND DO NOT SUBSTITUTE FORMS

PLEASE READ CAREFULLY:

Attachment B is a consolidated document consisting of:

1. Business License Number Requirement (must be provided)

2. Acknowledgement of Addenda (must be acknowledged, if any)

3. Statement of Non-Discrimination

4. Non-Collusion Affidavit of Prime Proponent/Offeror

5. Conflict of Interest

6. Contractor Affidavit and Agreement (E-Verify User ID Number must be provided)

Attachment B Must be Notarized & Two (2) Pages Must be returned with your submittal - No Exceptions.

Business License Requirement: Proponent must be licensed in the Governmental entity for where they do the majority of their business. Your company’s business license number must be provided on Page 1 of Attachment B. If your Governmental entity (State or Local) does not require a business license, your company will be required to obtain a Richmond County business license if awarded a contract. For further information contact the License and Inspection Department @ 706 312-5050.

Acknowledgement of Addenda: You Must acknowledge all Addenda. See Page 1 of Attachment B.

E-Verify * User Identification Number (Company I.D.) The recommended awarded vendor will be required to provide a copy of Homeland Security’s Memorandum Of Understanding (MOU). Contractors, Bids, RFPs, RFQs - Any contractors performing the physical performance of services” for your city, including those that respond to bids or requests for proposals, must submit an E-Verify affidavit. Your city cannot consider any contractors, even as part of a bidding or RFP process, unless they have given you the appropriate E-Verify contractor affidavits.

Contractors are defined as those who provide any “physical performance of services,” which means any performance of labor or services for a public employer using a bidding process or by contract that costs over $2,499.99 in value between December 1 and November 30 of any given year. Typically, eligible contracts may include: New construction or the demolition of structures/roads Routine operation, repair, and maintenance of existing structures. Any contracts for labor and service that exceed $2,499.99. Contracts for the purchase of goods without any services provided are not subject to these E-Verify requirements.

The city, each contractor, and each subcontractor have different roles and responsibilities in the E-Verify process. The city collects E-Verify affidavits from the contractor. The contractor collects E-Verify affidavits from its subcontractors. The subcontractors collect E-Verify affidavits from its sub-subcontractors. Independent contractors (those with no employees) do not need to supply E-Verify information. Instead, they will provide a driver’s license or state identification card from states on the “compliant” list created by the Georgia Attorney General. Those contractors and subcontractors that fill out the affidavits are responsible for the accuracy of the information. The city does not need to confirm that the E- Verify information is correct. The liability for incorrect information is on the contractor or subcontractor. NOTE: The authorization date can be found within the Memorandum of Understanding (MOU).

Affidavit Verifying Status for Augusta Benefit Application (S.A.V.E. Program) (Must Be Returned With Your Submittal)

The successful proponent will submit the following forms to the Procurement Department no later than five (5) days after receiving the “Letter of Recommendation” (Vendor’s letter will denote the date forms are to be received)

1. Georgia Security and Immigration Subcontractor Affidavit

2. Non-Collusion Affidavit of Sub-Contractor

3. PLEASE NOTE GEORGIA LAW CHANGE: E-Verify and Public Contracts: The Georgia E-Verify law requires contractors and all sub-contractors on Georgia public contract (contracts with a government agency) for the physical performance of services over $2,499 in value to enroll in E-Verify, regardless of the number of employees. They may be exempt from this requirement if they have no employees and do not plan to hire employees for the purpose of completing any part of the public contract. Certain professions are also exempt. All requests for proposals issued by a city must include the contractor affidavit as part of the requirement for their bid to be considered.

WARNING: Please review “Notice to Proponent” regarding Augusta Georgia’s Local Small Business Opportunity Program Proponent Requirements.

Vendors are cautioned that acquisition of proposal documents through any source other than the office of the Procurement Department is not advisable. Acquisition of proposal documents from unauthorized sources places the proposer at the risk of receiving incomplete or inaccurate information upon which to base his qualifications.

Proposals are publicly opened. It is your responsibility to ensure that your company has met the Specifications and Licenses requirements prior to submitting a proposal.

Rev. 04/09/21

Attachment B

You Must Complete and Return the 2 pages of Attachment B with Your Submittal. Document Must Be Notarized.

Augusta, Georgia Augusta Procurement Department ATTN: Procurement Director 535 Telfair Street, Suite 605

Name of Proponent: _______________________________________________________________________________

Street Address: ___________________________________________________________________________________

City, State, Zip Code: ______________________________________________________________________________

Phone: ______________________ Fax: __________________________Email: ________________________________

Do You Have A Business License? Yes: ______ No: ______

Augusta, GA Business License # for your Company (Must Provide): ______________________________________

And/or Your State/Local Business License # for your Company (Must Provide): _____________________________

Utility Contractors License # (Must Provide if applicable): _______________________________ MUST BE LISTED ON FRONT OF ENVELOPE

General Contractor License # (Must Provide if applicable): _______________________________________________

Additional Specialty License # (Must Provide if applicable): ______________________________________________

NOTE: Company must be licensed in the Governmental entity for where they do the majority of their business. If your Governmental entity (State or Local) does not require a business license, please state above (Procurement will verify), your company will be required to obtain a Richmond County business license if awarded a BID. For further information regarding Augusta, GA license requirements, please contact the License and Inspection Department @ 706 312-5050.

List the State, City & County that issued your license: ___________________________________________________________

Acknowledgement of Addenda: (#1) ____: (#2) ____: (#3) ____: (#4) ____: (#5) ____: (#6) ____: (#7) ____: (#8) ____:

NOTE: CHECK APPROPRIATE BOX (ES) - ADD ADDITIONAL NUMBERS AS APPLICABLE

Statement of Non-Discrimination

The undersigned understands that it is the policy of Augusta, Georgia to promote full and equal business opportunity for all persons doing business with Augusta, Georgia. The undersigned covenants that we have not discriminated, on the basis of race, religion, gender, national origin or ethnicity, with regard to prime contracting, subcontracting or partnering opportunities.

The undersigned covenants and agrees to make good faith efforts to ensure maximum practicable participation of local small businesses on the proposal or contract awarded by Augusta, Georgia. The undersigned further covenants that we have completed truthfully and fully the required forms regarding good faith efforts and local small business subcontractor/supplier utilization.

The undersigned further covenants and agrees not to engage in discriminatory conduct of any type against local small businesses, in conformity with Augusta, Georgia’s Local Small Business Opportunity Program. Set forth below is the signature of an officer of the proposer/contracting entity with the authority to bind the entity.

The undersigned acknowledge and warrant that this Company has been made aware of understands and agrees to take affirmative action to provide such companies with the maximum practicable opportunities to do business with this Company;

That this promise of non-discrimination as made and set forth herein shall be continuing in nature and shall remain in full force and effect without interruption;

That the promises of non-discrimination as made and set forth herein shall be and are hereby deemed to be made as part of and incorporated by reference into any contract or portion thereof which this Company may hereafter obtain and;

That the failure of this Company to satisfactorily discharge any of the promises of nondiscrimination as made and set forth herein shall constitute a material breach of contract entitling Augusta, Georgia to declare the contract in default and to exercise any and all applicable rights remedies including but not limited to cancellation of the contract, termination of the contract, suspension and debarment from future contracting opportunities, and withholding and or forfeiture of compensation due and owing on a contract.

Non-Collusion of Prime Proponent

By submission of a proposal, the vendor certifies, under penalty of perjury, that to the best of its knowledge and belief:

(a) The prices in the proposal have been arrived at independently without collusion, consultation, communications, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other vendor or with any competitor.

(b) Unless otherwise required by law, the prices which have been quoted in the proposal have not been knowingly disclosed by the vendor prior to opening, directly or indirectly, to any other vendor or to any competitor.

(c) No attempt has been made, or will be made, by the vendor to induce any other person, partnership, or corporation to submit or not to submit a proposal for the purpose of restricting competition. Collusions and fraud in proposal preparation shall be reported to the State of Georgia Attorney General and the United States Justice Department.

You Must Complete and Return the 2 pages of Attachment B with Your Submittal. Document Must Be Notarized.

Rev. 4/09/21

Conflict of Interest PAGE 2 OF 2 By submission of a bid, the responding firm certifies, under penalty of perjury, that to the best of its knowledge and belief:

1. No circumstances exist which cause a Conflict of Interest in performing the services required by this BID, and

2. That no employee of the County, nor any member thereof, not any public agency or official affected by this BID, has any pecuniary interest in the business of the responding firm or his sub-consultant(s) has any interest that would conflict in any manner or degree with the performance related to this BID. By submission of a bid, the vendor certifies under penalty of perjury, that to the best of its knowledge and belief:

(a) The prices in the bid have been arrived at independently without collusion, consultation, communications, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other vendor or with any competitor.

(b) Unless otherwise required by law, the prices which have been quoted in the bid have not knowingly been disclosed by the vendor prior to opening, directly or indirectly, to any other vendor or competitor.

c) No attempt has been made, or will be made, by the vendor to induce any other person, partnership, or cooperation to submit or not to submit a bid for the purpose of restricting competition. For any breach or violation of this provision, the County shall have the right to terminate any related contract or agreement without liability and at its discretion to deduct from the price, or otherwise recover, the full amount of such fee, commission, percentage, gift, payment, or consideration.

Contractor Affidavit and Agreement: Contractor Affidavit under O.C.G.A. § 13-10-91(b) (l)

GEORGIA E-Verify and Public Contracts: The Georgia E-Verify law requires contractors and all sub-contractors on Georgia public contract (contracts with a government agency) for the physical performance of services over $2,499 in value to enroll in E-Verify, regardless of the number of employees. They may be exempt from this requirement if they have no employees and do not plan to hire employees for the purpose of completing any part of the public contract. Certain professions are also exempt. All requests for proposals issued by a city must include the contractor affidavit as part of the requirement for their bid to be considered.

The undersigned contractor ("Contractor") executes this Affidavit to comply with O.C.G.A § 13-10-91 related to any contract to which Contractor is a party that is subject to O.C.G.A. § 13-10-91 and hereby verifies its compliance with O.C.G.A. § 13-10-91, attesting as follows:

a) The Contractor has registered with, is authorized to use, and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program;

b) The Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof;

c) The Contractor will notify the public employer in the event the Contractor ceases to utilize the federal work authorization program during the contract period, including renewals or extensions thereof;

d) The Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of Contract;

e) The Contractor will contract for the performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the Contractor with the information required by O.C.G.A. § 13-10-91(a), (b), and (c);

f) The Contractor acknowledges and agrees that this Affidavit shall be incorporated into any contract(s) subject to the provisions of O.C.G.A. § 13-10- 91 for the project listed below to which Contractor is a party after the date hereof without further action or consent by Contractor; and

g) Contractor acknowledges its responsibility to submit copies of any affidavits, drivers' licenses, and identification cards required pursuant to O.C.G.A. § 13-10-91 to the public employer within five business days of receipt.

Georgia Law requires your company to have an E-Verify*User Identification Number (Company I.D.) on or after July 1, 2009.

For additional information or to enroll your company, visit the State of Georgia website:

https://e-verify.uscis.gov/enroll/ and/or http://www.dol.state.ga.us/pdf/rules/300_10 1.pdf

Federal Work Authorization User Identification Number: E-VERIFY REQUIRED FOR ALL CONTRACTS OVER $2,499.00 Date of Authorization

** (E-Verify Number) ___________________________________________ _________________________

Name of Contractor Name of Project / RFP Number

AUGUSTA, GEORGIA – RICHMOND COUNTY CONSOLIDATED GOVERNMENT

Name of Public Employer

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on _____________________________, 20________ in ___________________ (City), _______________ (State).

Signature of Authorized Officer or Agent Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME ON THIS THE _______ DAY OF ____________________________, 20_______

Notary Public My Commission Expires: NOTARY SEAL

The undersigned further agrees to submit a notarized copy of Attachment B and any required documentation noted as part of the Augusta, Georgia Board of Commissions specifications which govern this process. In addition, the undersigned agrees to submit all required forms for any subcontractor(s) as requested and or required. I further understand that my submittal will be deemed non-compliant if any part of this process is violated.

You Must Complete and Return the 2 pages of Attachment B with Your Submittal. Document Must Be Notarized.

https://e-verify.uscis.gov/enroll/ http://www.dol.state.ga.us/pdf/rules/300_10%201.pdf

You Must Complete and Return with Your Submittal. Document Must Be Notarized

Systematic Alien Verification for Entitlements (SAVE) Program

Affidavit Verifying Status for Augusta, Georgia Benefit Application By executing this affidavit under oath, as an applicant for an Augusta, Georgia Business License or Occupation Tax Certificate, Alcohol License, Taxi Permit, Contract, or other public benefit as reference in O.C.G.A. Section 50-36-1, I am stating the following with respect to my bid for an Augusta, Georgia contract for

[RFP Project Number and Project Name]

[Print/Type: Name of natural person applying on behalf of individual, business, corporation, partnership, or other private entity]

[Print/Type: Name of business, corporation, partnership, or other private entity]

1.) _________ I am a citizen of the United States.

OR

2.) _________ I am a legal permanent resident 18 years of age or older.

OR

3.) _________ I am an otherwise qualified alien (8 § USC 1641) or nonimmigrant under the Federal Immigration and

Nationality Act (8 USC 1101 et seq.) 18 years of age or older and lawfully present in the United States. *

In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia.

Signature of Applicant

Printed Name

*Alien Registration Number for Non-Citizens

SUBSCRIBED AND SWORN BEFORE ME ON THIS THE ___________ DAY OF ______________, 20____

Notary Public

My Commission Expires: _______________________________ NOTARY SEAL

Note: THIS FORM MUST BE COMPLETED AND RETURNED WITH YOUR SUBMITTAL

REV. 2/17/2016

TRADE SECRET STATUS AFFIDAVIT

Augusta, Georgia

All documents, data, letters and generated information received by Augusta, Georgia constitutes a “public record” and is subject to disclosure under the Georgia Open Records Act ("GORA"). O.C.G.A. § 50-18-70 et seq. However, pursuant to O.C.G.A.

§ 50-18-72(a)(34), "[an] entity submitting records containing trade secrets that wishes to keep such records confidential under this paragraph shall submit and attach to the records an affidavit affirmatively declaring that specific information in the records constitute trade secrets pursuant to Article 27 of Chapter 1 of Title 10 [O.C.G.A. § 10-1-760 et seq.].”

O.C.G.A. § 10-1-761(4) defines “Trade secret" as “…information, without regard to form, including, but not limited to, technical or nontechnical data, a formula, a pattern, a compilation, a program, a device, a method, a technique, a drawing, a process, financial data, financial plans, product plans, or a list of actual or potential customers or suppliers which is not commonly known by or available to the public and which information:

A. Derives economic value, actual or potential, from not being generally known to, and not being readily ascertainable by proper means by, other persons who can obtain economic value from its disclosure or use; and

B. Is the subject of efforts that are reasonable under the circumstances to maintain its secrecy.”

Therefore, the records listed below and attached hereto, that were submitted with _______________________response to Augusta, Georgia Request for Proposal, Request for Quote, or Request for Qualified Contractor ______________are marked confidential pursuant to O.C.G.A. § 10-1-761(4):

• (List specific information that the supplier wishes to withhold and how that information constitutes a trade secret)

• Additional trade secret information requested to be withheld

• Your company is requested to send a redacted copy of your submittal.

Under penalty of perjury, acknowledging that O.C.G.A. §16-10-71 provides a penalty of a fine of up to $1,000 and potential imprisonment of one to five years, I attest that the specific information in the records listed above constitutes trade secrets pursuant to O.C.G.A. § 10-1-761(4), and request that Augusta, Georgia not disclose this protected information under the Georgia Open Records Act ("GORA").

Signature:

[Signatory Name in Print] [Signatory’s Title] [Company Name]

_______________________________ Date: ______________________________________ [Signatory’s Title]

SUBSCRIBED AND SWORN BEFORE

ME ON THIS ______ DAY OF

_____________, 202_.

__________________________________ My Commission Expires: ______________

NOTARY PUBLIC

Return Page Only if Applicable

Minority and Women Owned Business Enterprise Program Ordinance Requirements Notice To All Bidders (PLEASE READ CAREFULLY) Shall apply to ALL Bids regardless of the dollar amount In accordance with the Commission Action on 7/25/24 and the adoption of Ordinance No. 7945 Chapter 10C of the AUGUSTA, GA, CODE, Contractors agree to collect and maintain all records necessary to Augusta, Georgia to evaluate the effectiveness of its Minority and Women Owned Business Enterprise Program and to make such records available to Augusta, Georgia upon request. The requirements of the Minority and Women Owned Business Enterprise Program can be found at www.augustaga.gov. In accordance with AUGUSTA, GA. CODE, Contractors shall report to Augusta, Georgia the total dollars paid to each subcontractor, vendor, or other business on each contract, and shall provide such payment affidavits, regarding payment to subcontractors, if any as required by Augusta, Georgia.

Such utilization reports shall be in the format specified by the Director of Compliance and shall be submitted at such times as required by Augusta, Georgia. Required forms can be found at www.augustaga.gov. If you need assistance completing a form or filing information, please contact the M/WBE Program office at (706) 821- 2406. Failure to provide such reports withing the time period specified by Augusta, Georgia shall entitle Augusta, Georgia to exercise any of the remedies set forth, including, but not limited to, withholding payment from the Contractor and/or collecting liquidated damages.

SHALL APPLY TO PROJECTS IN EXCESS OF $300,000

Minority and Women Owned Business Enterprise Program (Continued) Sec. 1-10-138. Race and Gender-Conscious Efforts Contract-by-Contract Subcontractor Goals The City, through the Goal Setting Committee (GSC), will set specific, separate percentage-based MBE and WBE subcontracting goals on a contract-by contract basis for Prime contracts in Construction, Architecture & Engineering, Professional Services, and Other Services valued in excess of $300,000. The City shall establish such goals based upon the type of contract, the type of subcontracting work that will be required, and the availability of M/WBE firms to perform the work for that specific contract.

The GSC shall not establish subcontracting goals on contracts where (a) there are no subcontracting opportunities identified for the contract; or (b) there are not at least three (3) MBE and/or WBE firms that are available and capable to perform a CUF for the overall subcontracting opportunities on the contract.

Good Faith Efforts (GFE) Requirements and Guidance 1.Achievement of subcontracting goals or documentation of Good Faith Efforts applies to every Contract for which such goals are established. The Bidder shall submit a compliance plan detailing its achievement of the goals or its Good Faith Efforts to meet the goals. The compliance plan shall be due at the time set out in the solicitation documents.

2.When a Bidder cannot achieve the goals, its compliance plan shall document its GFE to achieve the goals. The Director of Compliance will determine whether the Bidder has made such GFE.

Bid Documents All bid documents shall require bidders or proponents to submit with their bid the following written documents, statements, or forms, which shall be made available by the Procurement Department.

• Proposed Letter of Intent MBE/WBE.

• Proposed MBE/WBE Utilization Plan.

• Documentation of Good Faith Efforts Form (in the event the bidder will not meet the MBE and WBE goals).

Failure to submit the above documentation shall result in the bid being declared non-responsive.

Sec. 1-10-154.Exceptions In accordance with § 1-10-8, on federally funded projects or contracts, the M/WBE Program shall only be utilized when authorized by the applicable federal (and/or Georgia) laws, regulations, and conditions relating to that project or contract. To the extent that there are any conflicts between any such laws, regulations, or conditions and the provisions of the M/WBE Program, the federal (and/or Georgia) guidance shall control.

NOTE: All forms should be submitted in a separate, sealed envelope, labeled M/WBE Forms, Company’s Name & Bud number

For questions and or additional information, please contact:

Minority-Owned and Women-Owned Business Enterprise Program

535 Telfair Street, Suite 530 Augusta, Georgia 30901

(706) 821-2406 mwbe@augustaga.gov

Website: https://www.augustaga.gov/83/Disadvantaged- Business-Enterprise

REV. 9/6/24

mailto:mwbe@augustaga.gov https://www.augustaga.gov/83/Disadvantaged-Business-Enterprise https://www.augustaga.gov/83/Disadvantaged-Business-Enterprise

INSTRUCTION TO PROPOSERS

Augusta, Georgia is seeking proposals from vendors to provide Third Party Administration Services for Workers Compensation for the Finance Department. Your submittal should respond to, and be based on, the information included in this Request for Proposal.

Responses will be received in the office of the Director of Procurement at 535 Telfair Street, Suite 605, Augusta, GA 30901 until Monday, December 30, 2024 @ 1:00 p.m. The RFP must be submitted in a sealed package and labeled with firm’s name and the name of the project - RFP 25-123 Third Party Administrative Services for Workers Compensation. Vendors are required to submit one (1) marked unbound original and seven (7) copies of the RFP.

RFP Opening will be via ZOOM – Meeting ID: 846 7480 7796; Passcode: 25123.

No RFP will be accepted by fax or email, all must be received by mail or hand delivered. If RFP is forwarded by mail or other second party delivery, the sealed envelope containing the submittal bust be enclosed in an envelope addressed to:

Darrell White Interim Procurement Department

535 Telfair Street - Room 605

To ensure timely deliveries, all submittals must be received during our normal office hours from 8:30 a.m. to 5:00 p.m., Monday through Friday. No deliveries will be accepted prior to 8:30 a.m. or after 5:00 p.m., as the building is closed to the public and delivery services outside of these hours.

RFP Packages may be obtained at the Augusta, Georgia Procurement Department, at the address listed above.

All firms responding are cautioned to read this Request for Proposals (RFP) carefully for understanding and request clarification from Augusta, Georgia on any questions pertaining to this RFP. The Proposer should examine all documents and requirements of the services requested to become fully informed. Failure to examine these areas will not relieve the successful Proposer of its obligation to furnish all products and services necessary to carry out the provisions of the contract. After RFPs have been submitted, the vendor shall not assert that there was a misunderstanding concerning the quantities of work or of the nature of the work to be done.

All questions must be submitted to the Procurement Department in writing by fax to 706 821-2811 or by email to procbidandcontract@augustaga.gov by Friday, December 13, 2024 @ 5:00 P.M. Issues and responses addressed in any other manner will not be considered valid or binding in consideration of proposals or any subsequent contract negotiations. Failure to provide all the requested information may cause the submittal to be rejected as non-responsive.

Failure to provide all the requested information may cause the RFP to be rejected as non-responsive. An official authorized to bind the firm to the terms and provisions of the RFP must sign. The Proposer’s response must include a service proposal and fee proposal as well as all other information requested in this RFP. The fees must be the full cost to Augusta. Augusta, Georgia will consider the degree to which each Proposer has submitted a complete Service and Fee Proposal without irregularities, excisions, special conditions, or alternative proposals for any item unless specifically requested in the RFP.

The contract will be awarded, if awarded, to the most responsive and responsible Proposer. If an award of contract is made as a result of this solicitation, contract will be made on the basis of the response which best satisfies the intent of this Request for Proposals and other factors considered in the best interest of the Owner.

Negotiations may be undertaken with those firms who proposal shows them to be qualified, responsible, and capable of performing the work. The Owner will consider professional qualifications and related experience to determine which proposal would be in Owner’s best interest if a contract were made. The Owner reserves the right to consider proposals or modification thereof received at any time before the award is made if such action is in the interest of the Owner.

Any interested qualified firm and/or party is requested to make a response to accomplish the Scope of Services described herein. The response is to be signed by a duly authorized official of the firm and must be submitted in the time, manner and form prescribed.

The Owner reserves the right to reject any or all statements received as the result of this request. The Owner also maintains the right to negotiate with any firm, as necessary, to serve the best interests of Owner. The Owner will not be liable for any costs incurred by the firm prior to the signing of a contract.

An official authorized to bind the firm to the terms and provisions of the proposal must sign the proposal. No RFP may be withdrawn for a period of 90 days after RFP have been opened, pending the execution of contract with the successful proposer(s). The information contained in this RFP defines and describes the services requested.

The proposal shall be no more than sixty (60) pages in length, excluding cover letter, required forms, tabs, and appendices. All documents will be typewritten on standard 8 x 11 white paper. Exceptions to the minimum page limit would be schematics, exhibits, photographs or other information necessary to facilitate Augusta’s ability to accurately evaluate the proposal.

The Proposer must package and seal its proposals so that they will not be damaged in mailing. Proposers are reminded that under Georgia law, all opened documents fall under the Open Records Act and are subject to inspection by the public. Accordingly, proprietary information and/or data cannot be withheld from public inspection. All proposals and supporting documents will be submitted in accordance with the specifications.

See the Trade Secret Affidavit. Vendors are required to submit a redacted copy of their RFP submittal for any trade secret information contained in their RFP submittal.

It is Augusta’s intent to evaluate the proposals based on service merit and price and to choose the Proposer whose proposal provides the highest value to Augusta. Augusta reserves the right to waive any irregularities, reject any and/or all proposals, in whole or in part, when, in Augusta’s opinion, such rejection is in the best interests of Augusta.

The Owner will evaluate all statements received from firms with respect to evidence that the goals and objectives of the project are fully understood. The firm’s demonstrated technical capability and other qualifications, as described herein, will also be assessed. The Owner will then make their recommendation to the Augusta Commission for their consideration and final approval.

NOTE: Augusta reserves the right to accept a proposal, as submitted, and upon Commission approval enter into a contractual agreement with that selected Proposer. Consequently, it is imperative that all Proposers submit the best service and cost offer in the initial submission.

SECTION I

INTRODUCTION

1. Augusta, Georgia Information

Augusta, Georgia (hereinafter known as Augusta) is a progressive, expanding city. Augusta is a political subdivision of the State of Georgia, which includes the entire Richmond County area. The governing body is the Augusta Commission, which is comprised of a mayor and two super-district Commissioners and 8 single district Commissioners, all of which serve four year staggered terms. The daily operations of Augusta are run by an Administrator, who is appointed by and responsible to the Augusta Commission.

Services are provided to over 198,366 residents living in the 326 square mile area to include: public safety (fire and law enforcement), community development, community services, transportation, and other general governmental services. The government also provides water, sewer, and solid waste disposal services to the public. Approximately 2700+ employees are employed in support of these services.

2. Background

Augusta currently utilizes the services of a third party administrator to handle all aspects of workers compensation claims adjudication and payment. Augusta is interested in continuing to have a TPA provide these administrative services.

Augusta Risk Management plays a key but limited role in the claims administration process. A Program Coordinator is on staff and is responsible for providing the first report of injury, job descriptions, wage statements, and communicating pay status to the Third Party Administrator (TPA). The TPA’s major duties are processing all paperwork, determination of claims, doctor appointments, pharmaceutical management, return to work, rehabilitation, medical bills, etc. The TPA is responsible for the timely filing of all claims with the appropriate agency and the timely payment of all expenses associated with the claims handling process. The TPA handles any problems with treatment and addresses those issues with the doctor’s office, etc.

3. Proposers Response

This RFP includes detailed information that will enable the Proposers to prepare a detailed response.

Proposers should adhere to the specifications as presented and respond accurately and concisely to the questions.

4. Terms and Contractual Schedule It is anticipated that a contract will be awarded in 2025. Augusta intends to award a pre-event contract for an initial period of three (3) years with a possible two (2) subsequent one (1) year renewals upon mutual consent and agreement on fees. The extension options will require Commission approval. The first contract period will be for a thirty-six (36) month period beginning tentatively March 1, 2025 and ending February 29, 2028, with a mutually agreeable option to extend for two (2) additional one (1) year terms. Payment for administrative services will be issued at the beginning of each contract period. The first payment will be submitted at the beginning of the contract period for 2025, the second payment will be issued at the beginning of the contract period for 2026 and final payment submitted at the beginning of the contract period for 2027.

5. Termination Provision

Either party shall have the right to voluntarily terminate this agreement at any time upon written notice of cancellation or non-renewal to Augusta at least 180 days prior to the cancellation request or renewal date. Augusta may cancel at any time with a 60-day advance written notice to the company. All correspondence of this nature will be forwarded by certified or registered mail.

6. Proposal Responses

Proposers must agree that all responses, supplemental information, exhibits and other documentation can be incorporated into the resulting contract with Augusta. Contract language will be specific as to services being provided and cost and will be incorporated by reference or attachment, as appropriate.

7. Additional Condition:

If the TPA is sold or bought-out, Augusta reserves the right to review the new arrangement and terminate the contract with a 30 days’ notice.

SECTION II

QUESTIONNAIRE

All Proposers must complete the questionnaire in this section. This section should be included in your qualifications and experiencer section of your proposal.

If a particular question does not apply, type "NA" after the question.

General Information

A. What is your organization's full name and the address and telephone number for the location of your home office? Please list the location that would serve Augusta.

B. How long has your company been in the business of workers compensation third party administration? Has the company managed an average of 1,000 claims per year during the past three years? What is the average number of claims handled per adjustor?

C. Does the company have adequate resources to assign one adjuster to medical only claims and another adjuster to loss time claims? If so, will company make that assignment for Augusta Claims?

D. Has the company managed an average of $1 million in claims payout during the past three years?

E. By what means will Augusta be provided information on changes or proposed changes in legislation, rules and regulations affecting Augusta's responsibility as a self-insured employer?

F. Will company representatives be available to attend quarterly meetings with Augusta Risk Management staff at a location of Augusta’s choosing to discuss program progress and identify and recommend corrections in any problems in the existing program at no additional cost to Augusta? ______________

G. Will the company provide monthly claims reports that specify employee name, injury by type, department, division, current status, claims paid, reserves per claim and prior and current year-to-date costs? If so, provide sample reports.

H. Will the company provide quarterly reports that specify the top ten types of injuries by frequency and severity with cumulative YTD totals including break out by department and division? If so, provide sample reports. ___________

I. Will company provide special reports if requested by Augusta? If so, will there be an additional fee for this type of service? ____________

J. How will the company, in accordance with the requirements of the Georgia State Board of Workers’ Compensation and working with Augusta, review and process all injury and occupational disease cases reported, determine compensability, coordinate the provision of rehabilitative services, review all medical reports and bills concerning Workers’ Compensation claims to determine eligibility for payment considering injury, reasonableness of charges, necessity of treatment and potential for subrogation? _________

K. How will the company maintain both paper and computer files on each claim? Is it understood that all claim files, documentation and data of every kind prepared in whole or part by the Service Provider is Augusta's sole property and will be delivered to Augusta upon request or upon termination of this agreement and that Augusta has full and unlimited rights and title of these documents?