25-64121509-ITB Miscellaneous Property Attachment K Broker Information.pdf
PDF 84 KB Posted
- Attached to
- Inland Marine - Miscellaneous Property Insurance
- Solicitation number
- ITB-13034
- Issued by
- Leon County, Florida
About this file
This document is an Attachment K Broker Information form for Solicitation No. 25-64121509-ITB for Miscellaneous Property Insurance. The form is designed to collect detailed contact and administrative information from a broker who is submitting a bid for an insurance policy. The form requires the broker to provide key details such as their business name, Federal Employer Identification Number (FEIN), primary work location, and contact information for two potential points of contact - one responsible for administering the insurance policy and another who may answer questions about the bid.
The form is structured to capture comprehensive contact details, including names, titles, street addresses, email addresses, phone numbers, fax numbers, and emergency contact information. It appears to be part of a formal solicitation process for procuring property insurance, with the goal of identifying and documenting the specific broker and key personnel who will be responsible for the potential insurance contract. The form allows the purchasing agency to have multiple communication channels and clear lines of responsibility for the proposed insurance policy.
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Text version
Solicitation No. 25-64121509-ITB Miscellaneous Property Insurance Attachment K
Broker Information
Broker Name:
FEIN:
Primary Location(s) where the work will be performed:
Street Address:
City: ______________________________________
State:______________________________________
Please identify the person who is to be responsible for administering the Insurance Policy on your behalf if award is made.
Name:
Title:
Street Address:
E-mail Address:
Phone Number(s):
Fax Number:
Emergency Number:
If the person responsible for answering questions about the Broker’s Bid is different from the person identified above, please provide the same information for the person responsible for answering questions about the Broker’s Bid.
Name:
Title:
E-mail Address:
Phone Number(s):
Emergency Number:
File details come from the government source that posted it. Updated .