5-OESBD Ownership Disclosure

28 KB Posted

Attached to
Group Long Term Disability Insurance
Solicitation number
GEN2129113P1
Issued by
Broward County, Florida

About this file

This document is an Ownership Disclosure form from Broward County, Florida, related to a Group Long Term Disability Insurance solicitation. Broward County Human Resources Division is seeking a qualified firm to provide Group Long Term Disability Insurance, including enrollment support and administration services for benefit-eligible employees. The solicitation involves Project Specific Agreement GEN2129113P1 and requires electronic submission through BPRO (Broward Purchasing and Resource Optimization) by a specified closing date. Vendors must submit questions through BPRO by the designated question due date and are responsible for ensuring their response is received electronically.

The ownership disclosure is designed to collect vendor ownership information for research on potential contracting opportunity disparities, with explicit assurance that the information will not impact contract award decisions. The document emphasizes compliance with Section 287.05701 of Florida Statutes, which prohibits the county from requesting documentation or considering a vendor's social, political, or ideological interests when determining vendor responsibility. Vendors are instructed to submit the ownership disclosure form through a specific link, separate from the electronic bidding system, by 9/9/24. The solicitation includes additional requirements such as an ETS Vendor Security Questionnaire and considerations for Small Business Enterprises and County Business Enterprises.

Text of this file

OWNERSHIP DISCLOSURE

Broward County is collecting entity ownership information for Vendors. This is for informational purposes only and the data will be used for Broward County’s research on possible contracting opportunity disparities. The forms will be maintained separately from all other records of this solicitation and will be accessible only by authorized personnel. The information provided will not be used in determining whether the Vendor will receive a contract award. In accordance with Section 287.05701, Florida Statutes, the County may not request documentation or consider a vendor's social, political, or ideological interests when determining if the vendor is a responsible vendor or give preference to a vendor based on the vendor's social, political, or ideological interests.

Submit the form only through the link provided below. Do not submit the form as part of Vendor’s response in electronic bidding system.

Link for form submittal: Ownership Disclosure Form

Form Date 9/9/24

Other files

File Type Posted
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4-OESBD Affiliated Entities of the Principals Certification —
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15-Agreement Exceptions - RFP-RFQ-RLI.docx DOCX document
19-Foreign Country of Concern Attestation (PII).docx DOCX document
22-Pricing Worksheet, GEN2129113P1, Group Long Term Disability Insurance.xlsx XLSX spreadsheet
27-Addenda No. 2.pdf PDF
29-Attachment 2 - Group Claim Experience Report January 1, 2021 - June 30, 2025 Updated.pdf PDF
3-Lobbyist Registration Requirement Certification —
32-Submissions, GEN2129113P1, Group Long Term Disability Insurance.pdf PDF
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2-Summary of Vendor Rights for Broward County Competitive Solicitations —
28-Addenda No. 3.pdf PDF
31-619352 Incurred Paid Report January 1, 2021 - June 30, 2025.pdf PDF
8-Attachment 1 - Claims to Premium Report January 1, 2021 - December 31, 2024.pdf PDF
9-Evaluation Criteria, GEN2129113P1 Group Long Term Disability Insurance.pdf PDF
10-Plan Design Questionnaire, GEN2129113P1 Group Long Term Disability Insurance.docx DOCX document
17-Location Certification - RFP-RFQ-RLI.docx DOCX document
20-Criminal History Screening Practices Certification.docx DOCX document
21-ETS Vendor Security Questionnaire, GEN2129113P1, Group Long Term Disability Insurance.xlsx XLSX spreadsheet
23-Scope of Services, GEN2129113P1, Group Long Term Disability Insurance.pdf PDF
24-Addenda No. 1, GEN2129113P1, Group Long Term Disability Insurance.pdf PDF
26-Vendor Questionnaire and Standard Certifications - RFP-RFQ-RLI.docx DOCX document
6-Litigation History —
Show all 31

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