26-HR09 RFP Form B.PDF

PDF 133 KB Posted

Attached to
HEALTH INSURANCE AND BENEFIT BROKER
Solicitation number
26-HR09
Issued by
Dane County, Wisconsin

About this file

This is a Receipt of Forms and Submittal Checklist (Form B) for RFP 26-HR09 issued by the City of Wisconsin for a health insurance and benefits broker engagement covering the period 2027-2029. The RFP requires proposers to submit a comprehensive application package including a Signature Affidavit (Form A), Vendor Profile (Form C), References (Form D), Insurance Requirements documentation (Form E), a sealed Fee Proposal (Form F), and a Sustainability Questionnaire (Form G). All submissions must be accompanied by acknowledgment of receipt of this form and adherence to the Standard Terms and Conditions outlined in Appendix A. The checklist serves as verification that vendors have received all required forms and understand the complete submittal requirements for this procurement.

The document does not specify pricing terms, response deadlines, bid opening dates, site visit requirements, or bidder conference details within the form itself. These substantive procurement parameters, along with information regarding any set-asides, incumbent contractor status, contract award timeline, and funding sources, would be contained in the primary RFP document and related exhibits not included in this particular form. Vendors must ensure all required documentation is completed and submitted according to the specifications outlined in the complete RFP package.

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Other files

File Type Posted
City of Sun Prairie 2026 Renewal Folder.pdf PDF
26-HR09 RFP Form D.PDF PDF
26-HR09 RFP.PDF PDF
26-HR09 RFP Form F.PDF PDF
26-HR09 Draft Contract.PDF PDF
26-HR09 Appendix A.PDF PDF
26-HR09 RFP Form E.PDF PDF
26-HR09 RFP Form C.PDF PDF
26-HR09 QA FORM.PDF PDF
City of Sun Prairie 2025 Renewal Folder.pdf PDF
26-HR09 RFP Form A.PDF PDF
26-HR09 RFP Form G.PDF PDF
Census Data.xlsx XLSX spreadsheet
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Text version

This form must be returned with your response.

Proposers hereby acknowledge the receipt and/or submittal of the following forms:

Forms Initial to

Acknowledge

SUBMITTAL

Initial to Acknowledge

RECEIPT

Description of Services/Commodities N/A

Form A: Signature Affidavit

Form B: Receipt of Forms and Submittal Checklist

Form C: Vendor Profile

Form D: References

Form E: Insurance Requirements

Form F: Fee Proposal in separate sealed envelope

Form G: Sustainability Questionnaire

Appendix A: Standard Terms & Conditions N/A

VENDOR NAME

Form B: Receipt of Forms and Submittal Checklist

RFP #: 26-HR09

File details come from the government source that posted it. Updated .