Attachment E - Bidder Information Sheet.pdf
PDF 140 KB Posted
- Attached to
- KYTC Workers Comp Excess Insurance
- Solicitation number
- RFB 758 2200000059 3
- Issued by
- Elliott County, Kentucky
About this file
This is a Bidder Information Sheet for excess workers' compensation insurance issued by the Commonwealth of Kentucky through the Kentucky Transportation Cabinet in accordance with KRS 45A competitive bidding requirements. The document outlines mandatory submission requirements and compliance obligations for all bidders participating in this procurement process. Bidders must designate an agent responsible for account handling and a company representative available for immediate consultation, identify the claims office and supervising claims person, and commit to providing annual claims summary reports by May 25th of each succeeding policy year. All bidders are required to submit one marked copy and three additional copies of all insuring agreements, endorsements, and related documents for Commonwealth review, with the understanding that quoted coverage must be at least as broad as the current policy. Bidders must note any deviations from or enhancements to bid specifications on the appropriate forms and must sign and return the Invitation for Bid, Bidder Information Sheet, Bid Quotation Form 1, Bid Specification Deviation Form 1A, and Bid Specification Enhancement Form 1B with their submission; failure to do so will result in bid rejection.
The document requires bidders to provide their company's A.M. Best's Rating and Certificate of Authority number as part of the submission. This Bidder Information Sheet must be completed and submitted with the bid as a mandatory prerequisite for bid consideration. The form does not specify pricing terms, contract duration, or renewal options, as those details are referenced in related bid specification documents not included in this particular attachment.
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Text version
BIDDER INFORMATION SHEET
EXCESS WORKERS' COMPENSATION INSURANCE
COMMONWEALTH OF KENTUCKY
KENTUCKY TRANSPORTATION CABINET
THROUGH A COMPETITIVE BIDDING PROCESS
IN ACCORDANCE WITH KRS 45A
BIDDER INFORMATION SHEET
The following is to be completed and agreed to by all bidders:
1. ______________________________________________________________ will be the agent responsible for handling this account, and ______________________________________________ will be the company representative assigned to this account. Each will be available for immediate consultation.
2. _______________________________________________________________ Claims Office will supervise and adjust all reported losses and claims.
__________________________________________________________________ is the supervising claims person on this account.
3. We agree to provide an annual claims summary report for each policy year by May 25th of each succeeding year.
4. We have enclosed one (1) marked and (3) three copies of all insuring agreements, endorsements, etc., for review by the Commonwealth of Kentucky. The sample policy and endorsements will reflect the minimum coverage in the bid specifications. We understand that coverage quoted shall be at least as broad as the current policy.
5. We have noted deviations from or enhancements to the bid specifications, if any, on BID
SPECIFICATIONS DEVIATION FORM 1A. or BID SPECIFICATION ENHANCEMENT
FORM 1B.
6. The INVITATION FOR BID, BIDDER INFORMATION SHEET, BID QUOTATION FORM 1, BID SPECIFICATION DEVIATION(S) FORM 1A, and BID SPECIFICATION ENHANCEMENT(S) FORM 1B have been signed and returned with bid. We understand that failure to do so will be cause for rejection.
Company Representative __________________________________________________ (Signature) (Type Name and Title) Company's A. M. Best's Rating ______________________________ Company's Certificate of Authority No. ________________________ Date ___________________________________________________
NOTE: THIS BIDDER INFORMATION SHEET IS TO BE COMPLETED AND SUBMITTED WITH YOUR BID.
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