Attachment E - Bid Quotation Form 1.pdf

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Attached to
KTRS FIDUCIARY LIABILTY INSURANCE
Solicitation number
RFB-758-2400000300-3
Issued by
Elliott County, Kentucky

About this file

This document is the Bid Quotation Form 1 for RFB 758 2400000300 KTRS Fiduciary Liability Insurance issued by the Kentucky Teachers' Retirement System (KTRS). The desired coverage is for Fiduciary Liability and Defense Costs Insurance with a policy period from January 30, 2024 to January 30, 2025 and a retroactive date of November 30, 1985. The requested limit of insurance is $10,000,000 each claim and $10,000,000 annual aggregate with a $500,000 deductible.

The premium for this coverage, including the 1.8% Kentucky Surcharge and 3% Surplus Lines Tax (if applicable), must be provided by the bidder. The contract will be awarded to a responsive and responsible bidder with a Certificate of Authority from the Commonwealth of Kentucky. If there are no such bidders, bids will be accepted from eligible surplus lines insurers pursuant to KRS 304.10-040.

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ATTACHMENT E – BID QUOTATION FORM 1

RFB 758 2400000300

KTRS FIDUCIARY LIABILITY INSURANCE

Invitation No. Date: _

DESIRED COVERAGE

Fiduciary Liability and Defense Costs Insurance

POLICY PERIOD

12:01 a.m. January 30, 2024 to 12:01 a.m. January 30, 2025

RETROACTIVE DATE:

November 30, 1985

LIMIT OF INSURANCE

Provide a bid response on the following limit/deductible:

$10,000,000 each claim $10,000,000 annual aggregate $ 500,000 deductible

TAXES

1.8% Kentucky Surcharge $

3% Surplus Lines Tax (if applicable) $

TOTAL PREMIUM {INCLUDING TAX\

(Name of Insurance Agency) (Name of Insurer)

(Signature of Agency Authorized Rep) (Date)

(Agency Authorized Rep - Print Name)

(Title) (Telephone)

LEGAL REQUIREMENTS
TAXES
BIDDER ELIGIBILITY
If there are no responsive and responsible bidders with Certificates of Authority from the Commonwealth of Kentucky, bids will be accepted pursuant to KRS 304.10-040 as a condition for export; these bids shall be from an "eligible surplus lines insure...
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