Attachment F - Bid Quotation Form 1 - RFB 758 2300000459.pdf
PDF 110 KB Posted
- Attached to
- KDVA Directors & Officers Liability Insurance
- Solicitation number
- RFB 758 2300000459 3
- Issued by
- Greenup County, Kentucky
About this file
This is a Bid Quotation Form for RFB 758 2300000459 issued by the Kentucky Department of Veterans Affairs (KDVA) for Directors & Officers Liability and Employment Practices Liability Insurance. The coverage is requested on a claims-made basis for the named insured, with a policy period running from 12:01 a.m. March 31, 2023 through 12:01 a.m. March 31, 2024. Bidders are required to provide premium quotes for a limit of insurance of $2,000,000 per claim with a $2,000,000 general aggregate, with nil deductibles for both Directors & Officers claims and Employment Practices claims.
Pricing shall include the base premium for the stated coverage limits, a 1.8% Kentucky Surcharge, and a 3% Surplus Lines Tax if applicable, with all costs to be reflected in the total premium including tax line item. Bidders must submit their agency name, insurer name, authorized representative signature, date, printed name of authorized representative, title, and telephone number on the form. The form provides blank line items for the bidder to enter the premium amounts for each coverage component and the applicable taxes, with a final total premium due field.
View the file
Other files
Show all 16
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
RFB 758 2300000459
ATTACHMENT F – BID QUOTATION FORM 1
KDVA DIRECTORS & OFFICERS LIABILITY INSURANCE
BID QUOTATION FORM 1
Invitation No. _____________________ Date:________________________________________
DESIRED COVERAGE
Directors & Officers Liability/Employment Practices Liability Insured on a claims made basis for the named insured.
POLICY PERIOD
12:01 a.m. March 31, 2023 to 12:01 a.m. March 31, 2024
LIMIT OF INSURANCE
Provide bids on the following limits:
$2,000,000 each claim $________________ $2,000,000 general aggregate Nil deductible for each Directors & Officers claim $________________ Nil deductible for each Employment Practices claim
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)
RESTRICTION ON COMMUNICATIONS
File details come from the government source that posted it. Updated .