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 to affirm they do not have any prior involvement that would disqualify them from competing for the contract, specifically addressing restrictions outlined in section 287.057(19)(c) of Florida Statutes. The form provides space for a vendor's authorized representative to sign, print their name, and date the certification, confirming their eligibility to participate in the solicitation.

The certification prevents potential conflicts of interest by prohibiting firms that have previously performed feasibility studies, participated in drafting solicitation documents, or developed implementation programs from contracting with the agency on the same subject matter. The statute does allow respondents who have merely responded to a request for information to remain eligible for contract consideration. This document serves as a legal safeguard to ensure fair and unbiased competitive procurement processes, requiring vendors to self-certify their compliance with state procurement regulations before being considered for the contract opportunity.

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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 G PUR 7801.docx DOCX document
25-84131500-ITN DFS BOR Attachment C Technical Response.docx DOCX document
25-84131500-ITN DFS BOR Attachment I PUR 2023.pdf PDF
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25-84131500-ITN DFS BOR Attachment Q PUR 2024 Coercion Labor Services.pdf PDF
25-84131500-ITN DFS BOR Attachment X SRMTF Participating Agencies and Universities.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
25-84131500-ITN DFS BOR Attachment T Broker Report FY 2425.xlsx XLSX spreadsheet
25-84131500-ITN DFS BOR Attachment O Broker Information.pdf PDF
25-84131500-ITN DFS BOR Attachment F PUR 1000 General Contract Conditions.pdf PDF
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Text version

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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