Attachment_D_Certification_of_Financial_Condition.pdf
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- Solicitation number
- RFP-1-26-12
- Issued by
- Brevard County, Florida
About this file
This is a Certification of Financial Condition document related to a Florida county's Group Life & Disability and Supplemental Health Benefits contract opportunity. The county seeks to expand its voluntary benefit offerings by contracting with a single carrier/administrator to provide group-sponsored Accident, Hospital Indemnity, and Critical Illness/Cancer coverage effective January 1, 2027. Currently, the county offers fully insured Group Term Life, Accidental Death & Dismemberment, Short-Term Disability, and Long-Term Disability coverage through Standard Insurance Company under a contract awarded via RFP with an effective date of January 1, 2019. The supplemental health benefits are presently offered individually through multiple representatives including Aflac, Allstate, and Colonial Life, and proposers should not assume comparable group experience data is available for these lines.
Employees currently enrolled in individual Colonial, Aflac, and Allstate plans may continue those coverages on a direct-bill basis after the contract effective date, but the county will not permit on-site enrollment or payroll deductions for individual plans. Only group-sponsored benefits awarded through this solicitation will be eligible for payroll deduction and group administration beginning January 1, 2027. The certification document serves to verify the financial stability and condition of potential bidders responding to this solicitation, ensuring proposers have the necessary financial capacity to administer and manage the requested benefit programs for the county's eligible employees, dependents, and retirees.
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Text version
CERTIFICATION OF FINANCIAL CONDITION
Solicitation#:
Vendor Name:
The undersigned hereby certifies that: [check all applicable boxes]
D The Vendor is in sound financial condition and, if applicable, has received an unqualified audit opinion for the latest audit of its financial statements.
Date of latest audit: _________ (If no audit within past 18 months, explain reason below.)
D The Vendor has no outstanding liabilities, including tax and judgment liens, to the Internal Revenue
Service or any other government entity.
D The Vendor is current in all amounts due for payments of federal and state taxes and required employment-related contributions and withholdings.
D The Vendor is not the subject of any current litigation or findings of noncompliance under federal or state law.
D The Vendor has not been the subject of any past or current litigation, findings in any past litigation, or findings of noncompliance under federal or state law that may impact in any way its ability to fulfill the requirements of this Contract.
D He or she is authorized to make the foregoing statements on behalf of the Vendor.
Note: This shall constitute a continuing certification and Vendor shall notify the Purchasing Manager within 30 days of any material change to any of the representations made herein.
If any one or more of the foregoing boxes is NOT checked, Vendor shall explain the reason(s) in the space below. Failure to include an explanation may result in Vendor being deemed non responsive and its submission rejected In Its entirety.
Signature Date
Printed Name Title
[This Certification must be signed by an individual authorized to speak for the Vendor]
Brevard County Certification of Financial Condition Date: 03/2024
Financial Stability Clause
Financial Stability. As a condition of contract award, the Vendor must certify that it has the financial capacity to perform and to continue to perform its obligations under the Contract; that Vendor has no constructive or actual knowledge of an actual or potential legal proceeding being brought against Vendor that could materially adversely affect performance of this Contract; and that entering into this Contract is not prohibited by any contract, or order by any court of competent jurisdiction. Each Vendor shall certify it is financially stable by completing the CERTIFICATION OF FINANCIAL CONDITI ON. Brevard County, herein after "County", is requiring this certification to minimize potential issues from contracting with a Vendor that is financially unstable. From the date of the Certification to the expiration of the Contract, the Vendor shall notify the County within thirty (30) days of any occurrence or condition that materially alters the truth of any statement made in this Certification. The Purchasing Manager may require annual recertification of the Vendor's financial stability.
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| Solicitation: |
| Vendor Name: |
| If no audit within past 18 months explain reason: |
| Date: |
| Printed Name: |
| Title: |
| Check Box1: Off |
| Check Box2: Off |
| Check Box3: Off |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
File details come from the government source that posted it. Updated .