4886_Financial_Exhibit_Attachment_B_Final.xlsx

XLSX spreadsheet 23 KB Posted

Attached to
Request for Proposals - City of Chandler Employee Assistance Program ; HR5-918-4886
Solicitation number
BPM006831
Issued by
Maricopa County, Chandler City, Arizona

About this file

Financial Exhibit for City of Chandler Employee Assistance Program

This financial exhibit attachment is part of the City of Chandler's Request for Proposals (RFP #HR5-918-4886) for Employee Assistance Program services. The exhibit serves as the fee quotation form and supporting documentation package that offerors must complete and submit as part of their proposal response. The services are requested for an eligible employee population of 1,248 employees across the City of Chandler, comprising 217 Police Department members, 217 Fire Department members, and 814 other eligible employees. The RFP has a proposal due date of March 26, 2025, with contract services set to commence on January 1, 2026, and the exhibit requires all pricing and service details to be submitted in Excel format rather than PDF.

The fee quotation form requires offerors to provide pricing for a 10-visit EAP model on a per-member-per-month basis across a five-year contract period from January 1, 2026, through December 31, 2030, with annual pricing updates for each contract year. Offerors must complete all yellow-shaded cells in the exhibit and include detailed comments explaining their pricing structure without referencing other proposal materials. The exhibit requires offerors to specify pricing for core services including Critical Incident Stress Management hours and rates, orientation and training hours, mediation services, 24-hour crisis counseling, and additional services such as wellness coaching, online resources, and referrals to outside agencies. Offerors must also provide a provider counts exhibit identifying the number of available EAP counselors in each of twelve Arizona cities where City of Chandler employees may be located, and submit three current public sector client references and any information regarding terminated contracts. Set-up fees or one-time implementation fees are discouraged but may be included if necessary. All exhibits must be submitted in the specified Excel workbook format without altering pre-populated rows or extracting individual worksheets as separate files.

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File Type Posted
4886_RFP_FINAL.pdf PDF
4886_Addendum_1_FINAL.pdf PDF
4886_Questionnaire_Attachment_A_Final.xlsx XLSX spreadsheet

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Text version

Directions Exhibit Instructions to Offerors

When completing the exhibits in the Excel workbook, please follow the directions below:

1. Do not add or delete rows, columns or alter-pre-labeled text in the exhibits
2. Electronic copies of these exhibits must be returned in Excel. Do not provide in a PDF format.
3. Do not extract individual worksheets (exhibits) and submit as separate Excel workbooks in the electronic copy.
4. Exhibits with light yellow color-coded cells require Offeror responses. Do not leave blank as this may jeopardize a thorough understanding of your proposal.

5. Do not refer the reader to "see my price proposal" rather than completing the exhibits herein. Your Offer may be rejected for being incomplete.

Unauthorized replication or use of this financial workbook is prohibited.
Copyright © 2025 by Segal. All rights reserved.

Fee Sheet

CITY OF CHANDLER
RFP #HR5-918-4486
EAP SERVICES FEE QUOTATION FORM
Effective January 1, 2026
Please do not alter or delete pre-populated rows. Complete yellow shaded areas only. Refer to the Scope Of Work for services requested. Include comments (expand as needed) to help clarify your proposal pricing so that we are able to have a thorough understanding of your offer. Please do not refer to other RFP materials you provide to understand your pricing. All of your comments to support your pricing must be on this exhibit. Set-up fees or one time implementation fees are highly discouraged but may be listed in an appropriate row.
Offerors must complete and submit the Price Proposal in the format requested below.
The fee per member per month must be inclusive of all services proposed in response to the Scope of Services.
# of Eligible Employees1,2481/1/261/1/271/1/281/1/291/1/30
(217 PD, 217 Fire, 814 other eligible employees)12/31/2612/31/2712/31/2812/31/2912/31/30
EAP Services10 Visit
Model10 Visit
Model10 Visit
Model10 Visit
Model10 Visit

Model

Start Up Fees
Administrative Fee (PEPM)
Estimated Annual Premium$0$0$0$0$0
Critical Incident Stress Management (CISM) Services
How Many Hours Are Included without Extra Charge
Per Hour Rate for Additional Hours
Are There Any Additional Charges for Services?
Orientation / Training / Educational Seminars
How Many Hours Are Included without Extra Charge
Per Hour Rate for Additional Hours
Are There Any Additional Charges for Services?
Indicate How Many Hours Included or Additional Fee for:
Mediation for HR Referrals
24-Hour Telephonic Crisis Counseling
Internet Services
In-Person Health/Benefit Fair Representation (1 day per year)
Educational/Promotional Materials
Mediation / Management referrals for general counseling, job performance, and other related employment activities
Referrals to Outside Agencies for:
Child Care
Elder Care
Identity Theft Monitoring/Repair
Legal Services and Financial Services:
How Many Hours Included
Discount or Per Hour Rate for Additional Hours
Additional Services:
Unlimited online training modules
Unlimited online seminars
Unlimited online wellness resources
Wellness coaching and HRA
Nurseline
Other (Specify)
Other (Specify)
Other (Specify)
Authorized Signature
Vendor Name
Date
Contact Phone Number
Comments
Unauthorized replication or use of this financial workbook is prohibited.
Copyright © 2025 by Segal. All rights reserved.

Provider Counts

CITY OF CHANDLER
RFP #HR5-918-4486
EAP SERVICES PROVIDER COUNTS
Effective January 1, 2026
Provide a list of the number of available EAP counselors matched to the cities of this client’s employees on the grid below:
City# of EAP Counselors
Avondale
Chandler
Gilbert
Glendale
Goodyear
Litchfield Park
Mesa
Peoria
Phoenix
Queen Creek
Scottsdale
Tempe
Tolleson
Total0
Authorized Signature
Vendor Name
Date
Contact Phone Number
Comments
Unauthorized replication or use of this financial workbook is prohibited.
Copyright © 2025 by Segal. All rights reserved.

References

CITY OF CHANDLER
RFP #HR5-918-4486
EAP SERVICES REFERENCES
Effective January 1, 2026
Provide three client references similar in size and industry. Include contact name, title and phone number.
Current Public Sector Client References
Name of AgencyNumber of MembersName, Phone Number, and Email Address of Contact PersonClient Location (City/State)Contract Start Date

Provide reference information for any contracts that have been recently terminated.

Terminated Public Sector Client References
Name of AgencyNumber of MembersName, Phone Number, and Email Address of Contact PersonClient Location (City/State)Date of Termination
Authorized Signature
Vendor Name
Date
Contact Phone Number
Comments
Unauthorized replication or use of this financial workbook is prohibited.
Copyright © 2025 by Segal. All rights reserved.

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