3-3. Appendix B - Required Forms.pdf

Appendix B.01

PROPOSER'S STATEMENT

REGARDING INSURANCE COVERAGE

To Be Submitted with Proposal

PROPOSER HEREBY CERTIFIES that the Proposer has reviewed and understands the insurance coverage requirements specified in the Request for Proposals (RFP) #26- 07 for State Legislative Advocacy Services. Should the Proposer be awarded the contract for the work, Proposer further certifies that the Proposer can meet the specified requirements for insurance, including insurance coverage of the subcontractors, and agrees to name MST as Additional Insured for the work specified, unless otherwise requested as an exception on the form herein labeled RFP Compliance or Exception.

Name of Proposer (Person, Firm, or Corporation)

Signature of Proposer's Authorized Representative

Name & Title of Authorized Representative

Date of Signing

INSURANCE REQUIREMENTS AND LIMITS

General:

CONSULTANT, at its sole cost and expense, for the full term of this Contract (and any extensions thereof), shall obtain and maintain at minimum all of the following insurance coverage. Such insurance coverage shall allow and be endorsed primary coverage as respects MST and any insurance or self-insurance maintained by MST shall be excess of

CONSULTANT's insurance coverage and shall not contribute to it.

Types of Insurance and Minimum Limits

CONSULTANT shall obtain and maintain during the term of this Contract:

(a) Worker's Compensation and Employer's Liability Insurance in conformance with the laws of the State of California (not required for CONSULTANT 's or sub-CONSULTANTs providing MST written confirmation of having no employees) with limits of not less than one million dollars ($1,000,000) each accident, $1,000,000 by disease-policy, and $1,000,000 disease-each employee.

(b) CONSULTANT’s vehicles used in the performance of this Contract, including owned, non-owned (e.g. owned by CONSULTANT's employees), leased or hired vehicles, shall each be covered with Commercial

Automobile, Liability Insurance using Insurance Services Office (ISO)

Business Automobile Coverage form CA 00 01 (or equivalent) in the minimum amount of one million dollars ($1,000,000) combined single limit per accident for bodily injury and property damage.

(c) CONSULTANT shall obtain and maintain Commercial General Liability

Insurance coverage with coverage at least as broad as Insurance Services

Office (ISO) form CG 00 01 in the minimum amount of one million dollars

($1,000,000) per occurrence, two million dollars ($2,000,000) general aggregate, and one million dollars ($1,000,000) products and completed operations aggregate. The policy shall include a per project or per location general aggregate endorsement. If a per project/location endorsement is not available, the limit for the general aggregate shall be doubled. If

CONSULTANT maintains higher limits than the specified minimum limits, MST requires and shall be entitled to coverage for the higher limits maintained by CONSULTANT.

(d) CONSULTANT shall obtain and maintain Professional Liability insurance that insures against professional errors and omissions that may be made in performing professional services in the minimum amount of two million dollars ($2,000,000) per claim and in the aggregate. Any policy inception date, continuity date, or retroactive date must be before the effective date of the start of work, and CONSULTANT agrees to maintain continuous coverage through a period no less than three (3) years after completion of the work.

Other Insurance Provisions

(a) As to all insurance coverage required herein, any deductible or self-insured retention exceeding $5,000.00 shall be disclosed to and be subject to written approval by MST.

(b) Except Professional Liability, each insurance coverage required hereunder is to be provided as an “occurrence” form basis only.

(c) All required Automobile Liability Insurance and Commercial General

Liability Insurance shall contain the following endorsement as a part of each policy: “MST is hereby added as an additional insured as respects the operations of the named insured."

(d) All the insurance required herein shall include and contain the following clause: "It is agreed that this insurance shall not be canceled until thirty (30) days after MST shall have been given written notice of such cancellation or reduction." If a carrier will not provide the required notice of cancellation, the CONSULTANT shall provide written notice to MST of a cancellation no later than five (5) business days before cancellation.

(e) All required Workers’ Compensation, Automobile Liability Insurance and

Commercial General Liability shall contain and be endorsed with a waiver of subrogation in favor of MST.

(e) CONSULTANT shall notify MST in writing at least thirty (30) days in advance of any reduction in any insurance policy required under this Contract.

(f) CONSULTANT agrees to provide MST at or before the effective date of this

Contract with a certificate of insurance of the coverage and amendatory endorsements required.

(g) If CONSULTANT, for any reason, fails to maintain insurance coverage, which is required pursuant to this Contract, the same shall be deemed a material breach of contract. MST, at its sole option, may terminate this

Contract and obtain damages from the CONSULTANT resulting from said breach.

Appendix B.02

RFP COMPLIANCE OR EXCEPTION

(Proposer must complete and submit with their proposal)

PLEASE ONLY SELECT ONE

COMPLIANCE OR EXCEPTION TO THE TERMS AND CONDITIONS OF THE RFP

A. COMPLIANCE:

This is to certify that Proposer agrees and shall comply with the terms and conditions of the RFP, including the Sample Contract.

Firm Name: ___________________________________________________________

Proposer Signature: _____________________________________________________

Title: _________________________________________________________________

Date: _________________________________

B. EXCEPTION:

This is to certify that Proposer takes exception to the following terms and conditions of the RFP. Proposer must identify and list the terms and conditions by Section, page number and title. Proposer must identify what its exception is.

Firm Name: ___________________________________________________________

Proposer Signature: _____________________________________________________

Title: _________________________________________________________________

Date: _________________________________

Proposer shall list and attach to this form proposer’s exception(s):

Appendix B.03

PRICE PROPOSAL

Pursuant to the Request for Proposals (RFP) #26-07, the undersigned firm submits a Price Proposal on this Price Proposal Form and binds itself on award by MST under this proposal to execute a Contract in accordance with its proposal, the Request for Proposals, and the award. The RFP, including the Notice Inviting Proposals, Technical Specifications, Sample Contract, Forms, and Addenda, if any, are made a part of this proposal and all provisions thereof are accepted, and all representations and warranties required thereby are hereby affirmed.

Fixed Monthly Fee (Initial Term):____________________________

Fixed Monthly Fee (Option Term):____________________________

The Fixed Monthly Fee submitted with this proposal shall cover the total cost for all materials, equipment, delivery charges, warranties, insurance, services, and all other costs necessary for furnishing the work under the contract for the RFP. The Fixed Monthly Fee represents all such costs for the duration of the contract. If the Fixed Monthly Fee from the Option Term line is left blank, the rate listed in the Initial Term line shall govern the rate for the Option Term.

Company Name: _______________________

Name (Print): __________________________

Title:_________________________________

Signature: ____________________________

Date: ________________________________