25-84131500-ITN DFS BOR Attachment S No prior involvement.pdf

PDF 107 KB Posted

Attached to
Insurance Broker of Record - Reinsurance Broker for Property and Casualty lines, Risk Management and
Solicitation number
ITN-13124
Issued by
St. Johns County, Florida

About this file

Attachment S is a Statement of No Prior Disqualifying Involvement document for Invitation to Negotiate (ITN) No. 25-84131500-ITN issued by the Florida Department of Management Services on behalf of the Department of Financial Services' Division of Risk Management. The document is a certification form that requires a respondent (vendor) to affirm they have no prior involvement that would disqualify them from contracting, specifically addressing restrictions outlined in section 287.057(19)(c) of Florida Statutes. The form requires the vendor's authorized representative to sign, confirming they have not been involved in drafting the solicitation, performing feasibility studies, or developing implementation programs that would prevent them from receiving the contract.

The form is part of a larger procurement process for a Broker of Record and Reinsurance Broker services contract, which prevents potential conflicts of interest by ensuring that entities who have been involved in preliminary contract preparation cannot subsequently bid on the same contract. By signing this document, the vendor attests that they have not engaged in activities that would render them ineligible, such as participating in feasibility studies or solicitation drafting for this specific procurement. The certification is a standard procedural requirement designed to maintain fairness and transparency in the state's competitive bidding process, ensuring that no vendor gains an unfair advantage through prior insider involvement in the contract development.

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25-84131500-ITN DFS BOR Attachment C Revised Technical Response.docx DOCX document
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25-84131500-ITN DFS BOR Attachment S No prior involvement.pdf PDF
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25-84131500-ITN DFS BOR Attachment J Cert of DFWorkplace.pdf PDF
25-84131500-ITN DFS BOR Attachment Q PUR 2024 Coercion Labor Services.pdf PDF
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25-84131500-ITN DFS BOR Attachment H Draft Contract.pdf PDF
25-84131500-ITN DFS BOR Attachment P Reference Form.pdf PDF
25-84131500-ITN DFS BOR Attachment N OOS WC Policy_Redacted.pdf PDF
25-84131500-ITN DFS BOR Attachment W Loss Detail.pdf PDF
25-84131500-ITN DFS BOR Attachment V Excess Policies 2025-2026 C.pdf PDF
25-84131500-ITN DFS BOR Attachment M Casualty Certificates of Coverage.pdf PDF
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25-84131500-ITN DFS BOR Attachment F PUR 1000 General Contract Conditions.pdf PDF
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ITN No.: 25-84131500-ITN

ITN No.: 25-84131500-ITN

Attachment S Statement Of No Prior Disqualifying Involvement

I, as an authorized representative of the Respondent, certify that nothing in section 287.057(19)(c), F.S., (below), prohibits the Respondent’s entry into any Contract resulting from this solicitation.

287.057 Procurement of commodities or contractual services. —

(19)(c) A person who receives a contract that has not been procured pursuant to subsections (1)-

(3) [of s. 287.057, F.S.] to perform a feasibility study of the potential implementation of a subsequent contract, who participates in the drafting of a solicitation or who develops a program for future implementation, is not eligible to contract with the agency for any other contracts dealing with that specific subject matter, and any firm in which such person has any interest is not eligible to receive such contract. However, this prohibition does not prevent a Respondent who responds to a request for information from being eligible to contract with an agency.

Respondent (Vendor) Name

Signature of Respondent’s Authorized Representative

Authorized Representative’s Printed Name

Date

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