Attachment H – Quarterly Performance Metrics Report Format.pdf

ATTACHMENT H - QUARTERLY PERFORMANCE MEASURES AND DELIVERABLES REPORT FORMAT

DELIVERABLES

Ongoing support to the

Department to meet the following requirements:

Senior Management Service

Optional Annuity Program

(SMSOAP) in accordance with section 401(a) of the Internal

Revenue Code; and

Compliance with the provisions of

Chapter 121, Florida Statutes

(.F.S.), and the rules promulgated thereunder in Chapters 60U and

60V, Florida Administrative Code

(F.A.C.).

Ongoing

$10,000, per occurrence, if the

Department is found to be non-compliant by the IRS, or other regulating authorities*, due to the

Contractor’s failure to meet requirements identified in Attachment

B – Statement of Work.

Select One $ -

Ongoing support to the

Department to meet the following requirements:

Ongoing State University System

Optional Retirement Program

(SUSORP) in accordance with section 403(b) of the Internal

Revenue Code; and

Compliance with the provisions of

Chapter 121, F.S., and the rules promulgated thereunder in

Chapters 60U and 60V, F.A.C.

Ongoing

$10,000, per occurrence, if the

Department is found to be non-compliant by the IRS, or other regulating authorities, due to the

Contractor’s failure to meet requirements identified in Attachment

B – Statement of Work.

Select One $ -

NUMBER OF

OCCURENCES DURING

THE REPORTING PERIOD

DELINQUENT

DAYS UNTIL

MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

*Regulating authorities may include, but are not limited to, local and state government (e.g., Office of Attorney General, Governor’s Office, etc.), where applicable.

NO. DELIVERABLES DUE DATE

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

TOTAL FINANCIAL CONSEQUECE ASSESSED $ -

DMS-24/25-199 Page 1 of 25 DELIVERABLES

PERFORMANCE MEASURES

1. 3.2.2.1

Preliminary

Implementation

Plan

100% $100, per Calendar Day, for each

Calendar Day beyond the 10 th day.

Select One $ -

2. 3.2.3.1

Final

Implementation

Plan

100% $100, per Calendar Day, for each

Calendar Day beyond the 10 th day.

Select One $ -

3. 3.2.3.4

Revised Final

Implementation

Plan

100%

$100, per Calendar Day, for each

Calendar Day beyond the 5 th Calendar

Day.

Select One $ -

4. 3.2.4 100% Operational

Deadline 100%

$5,000, per Calendar Day, until 100% operational.

Select One $ -

5. 3.3.2.1 Dedicated Account

Representatives 100%

$100, per Calendar Day, after the 10 th

Business Day, until the staffing level returns to five.

Select One $ -

$500, per occurrence, for failure to provide in its Final Implementation Plan.

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

6. 3.3.2.2 List of On-Site

Representatives 100% Select One $ -

DMS-24/25-199 Page 2 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

$100, per Business Day, until received by the Department.

8. 3.3.2.6

Account

Representative

Training

100% $10,000, if training does not occur as scheduled or as rescheduled.

Select One $ -

9. 3.3.4.2 Licensure Written

Certification 100%

$100, per Business Day, until received by the Department.

Select One $ -

10.

3.3.4.4, a. Vacant Positions 100%

$100, per Calendar Day, for each

Calendar Day beyond the 10 th day, until filled.

Select One $ -

6. 3.3.2.2 List of On-Site

Representatives 100% Select One $ -

11.

3.3.4.4, b.

Vacant Positions

Notifications 100%

$100, per occurrence, for failure to report vacancy within 24 hours.

Select One

7. 3.3.2.2

Updated List of On-

Site

Representatives

100% $100, per Business Day, after the 2nd

Business Day, until received.

Select One

DMS-24/25-199 Page 3 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Member Services

SUSORP

On-site

Requirements

Member Services

SUSORP

On-site

Requirements

Member Services

SUSORP

On-site

Requirements

Member Services

SUSORP

Meetings/On-site

Visits

12.

3.4.1.1 100%

$100, per Calendar Day, after the 20

Calendar Day, until received by the

Contractor.

13.

3.4.1.2 100%

$100, per Calendar Day, after the 3rd

Calendar Day received by the Service

Provider, until received by the

Department.

14.

3.4.1.3 100%

$500 per occurrence, of reported non-compliance at a university.

15.

3.4.1.4 100%

$500, per occurrence, for each non-attendance or non-scheduled visit.

DMS-24/25-199 Page 4 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Member Services

SUSORP and

SMSOAP

Authorized Product and Performance

Fees Member

Notification

Member Services

SUSORP and

SMSOAP

Authorized Product and Performance

Fees Member

Notification Method

17.

3.4.2.3, c. 100%

$500, per occurrence, for non-notification to the Department of notification delivery method.

Select One

16.

3.4.2.3, a. 100%

$100, per Member, for failure to provide the Member its notification.

Select One

DMS-24/25-199 Page 5 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Member Services

SUSORP and

SMSOAP

Quarterly Member

Statement

Communications

Revisions to Draft

Communications

Communications

Annual Marketing

Plan

18.

3.4.2.4 100%

$100, per occurrence, for each Member that did not have a quarterly statement available within time specified.

19.

3.5.6.2 100%

$100, per Calendar Day, after the 5th

Calendar Day, until received by the

Department.

Select One $ -

20.

3.5.7 100%

$100, per Business Day, each day after

January 31 st , until received by the

Department.

DMS-24/25-199 Page 6 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Member

Satisfaction Survey

Survey Results

Due Date

Website

Technical

Requirements

Website

Security

Requirements

21.

3.6.4, a. 100%

$500, per Business Day, each day after

December 31 st , until received by the

Department.

Select One $ -

23.

3.7.4., b.

≥ 99% of the time.

$250 per quarter, if less than 99%. Select One $ -

22.

3.6.4, c.

Annual Member

Satisfaction

Survey

≥ 90% $25,000, per annual occurrence, if less than 90% satisfaction rating.

24.

3.7.5 100%

$1,000, per occurrence, for each identified non-compliance.

DMS-24/25-199 Page 7 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Website

Website Updates

Toll-Free Number

Interactive Voice

Response (IVR)

System

Toll-Free Number

Hours and Days of

Operations

Call Center

Location

26.

3.8.2.1 100%

$100, per Business Day, after the 5th

Business Day, until received by the

Department.

25.

3.7.6 100%

$100, per Business Day, for each

Business Day, advance notification was missed.

Select One

27.

3.8.3.3 100%

$100, per Calendar Day, for each

Calendar Day, advance notification was missed.

28.

3.9.1 100%

$5,000, per occurrence, of reported non-compliance.

Select One $ -

29.

3.9.2

Call Center

Availability

≥ 99% of the time.

$6,500, per quarter, if less than 99%. Select One

DMS-24/25-199 Page 8 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Call Center

Resolve Member

Issues

Call Center

Incoming Calls

Call Center

Incoming Calls

Call Center

Investment

Transfers

34.

3.9.13

Call Center

Employees

Training

100% $1,000, per each staff member, who missed the annual training.

30.

3.9.5 100%

$250, per occurrence, for failure to resolve Member issues within five (5)

Business Days.

31.

3.9.7 80%

$250, per quarter, for failure to answer calls within thirty (30) seconds.

32.

3.9.7 100%

$250, per quarter, for calls on hold or in queue for more than sixty (60) seconds.

33.

3.9.11 100%

$500, per Member, for failure to process investment transfers received by 4:00pm

, EST before the next Business Day.

DMS-24/25-199 Page 9 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

3.10.1 thru

3.10.9

36.

3.11.3

Authorized

Products 100%

$1,000, per occurrence, for each non-

Authorized Product offered.

Select One $ -

Authorized

Products

Replacement

Authorized

Products

Deletion

Authorized

Products

Evaluation

Authorized

Products

Change

Implementation

37.

3.11.4.1 100%

$100, per Business Day, after the 20th

Business Day, until paid in full.

35.

Notifications 100%

$5,000, per occurrence, of non-notification.

Select One

38.

3.11.4.2 100%

Business Day, until paid in full.

39.

3.11.4.3 100%

Business Day, until paid in full.

Select One $ -

40.

3.11.4.4 100%

$100, per Business Day, after the 10th

Business Day, until submitted to the

Department.

DMS-24/25-199 Page 10 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Authorized

Products

Department

Product Review

In Good Order

Policy

Revised

41.

3.11.9 100%

$100, per Business Day, after the 90th

Business Day, until submitted to affected

Members.

Select One $ -

43.

3.12.2.2 100%

$100, per Business Day, after the 15th

Business Day, until submitted to the

Department.

42.

3.12.2.1

In Good Order

Policy 100%

$500, per occurrence, for failure to submit within 30 Calendar Days.

DMS-24/25-199 Page 11 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Contributions

Credits

Contributions

Outreach

Suspense Account

Corrections

Suspense Account

Return Funds

44.

3.12.3.1 100%

$2,500 per occurrence, and an individual

Member is made whole, as though the transaction occurred timely.

Select One $ -

46.

3.12.4.2 100%

$100, per Business Day, after the 10th

Business Day, until correction is made.

45.

3.12.3.2 100%

$100, per Member, not contacted by the

Contractor.

Select One

47.

3.12.4.3 100%

$100, per Business Day, after the date identified in the Final End of Service

Transition Plan, until funds are transferred or returned to the Department.

DMS-24/25-199 Page 12 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

48.

3.12.5.2

Rollover

Notification 100%

$1,000, per Business Day, after the 90

Department.

Select One $ -

Member

Distributions $1,000, per occurrence.

Failure to obtain

Department approval.

Member

Distributions

Process Time

50.

3.12.5.8 100%

$100, per Business Day, after the 5th

Business Day, until processed accurately and completely.

Select One

49. 3.12.5.5 100% Select One $ -

DMS-24/25-199 Page 13 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Member

Overpayments

(Unauthorized

Distributions)

Notification

Member

Overpayments

(Unauthorized

Distributions)

Correspondence

Member

Overpayments

(Unauthorized

Distributions)

Recapture

53 3.12.6.6 100%

Service Provider shall pay the gross amount of each distribution not retrieved by the 90th Calendar Day, from the date of notification by the Department.

Select One

100% $100, per Business Day, after the 10th

Business Day, until notification is sent.

Select One

52 3.12.6.4 100%

$100, per Business Day, after the 10th

Business Day, until the Department receives the correspondence.

Select One $ -

51 3.12.6.2

DMS-24/25-199 Page 14 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Member

Overpayments

(Unauthorized

Distributions)

Recapture Tax

Information

55 3.12.7.2

Member Social

Security Number

Discrepancy

100% $100, per Business Day, after the 10th

Business Day, until correction is made.

Select One $ -

Member Contract

Exchanges

Processing Time

56 3.12.8.2 100% $100, per Business Day, after the 5th

Business Day, until processed.

Select One

54 3.12.6.8 100%

$100, per Business Day, after the 10th

Business Day, until received by the

Department.

Select One

DMS-24/25-199 Page 15 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Member Contract

Exchanges

Restrict Contract

Exchanges

Authorized

Products within the

Plan.

Member Contract

Exchanges

Fund-to-Fund

Transfers

Member

Termination

Violation

Stop Payment

Member Forfeiture

57 3.12.8.4 100% $100, per Business Day, until correction is made.

Select One $ -

58 3.12.8.5 100%

$2,500, per occurrence, and Member is made whole, as though the transaction occurred timely.

Select One $ -

60 3.12.10.1 100%

Service Provider shall pay the gross amount of each unauthorized distribution it failed to stop.

Select One

59 3.12.9.1 100%

Service Provider shall pay the gross amount of each unauthorized distribution it failed to stop.

Select One

DMS-24/25-199 Page 16 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Hold/Stop Payment

61. 3.12.10.2 Member Forfeiture 100%

$100, per Business Day, after the 10th

Business Day, until benefits are placed in in Suspense Account.

Select One $ -

Rollovers

Notification

63 3.12.12 Non-Member

Account Resolution 100%

$1,000 per Business Day, after the 90

Calendar Day.

Reporting

Requirements

$250, per Business Day, starting

Tuesday (Business Day), until received by the Department.

Weekly

Distribution Report

60 3.12.10.1 100%

Service Provider shall pay the gross amount of each unauthorized distribution it failed to stop.

Select One $ -

62 3.12.11.2 100% $1,000, per occurrence, of non-notification.

Select One $ -

64 3.13.1 100% Select One $ -

DMS-24/25-199 Page 17 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Reporting

Requirements

$250, per Business Day, after the 10th

Business Day, until received by the

Department.

Quarterly

Suspense Account

Report

Reporting

Requirements

Quarterly Assets

Under

Management

Report

$250, per Business Day, after the 10th

Business Day, until received by the

Department.

Reporting

Requirements

Quarterly

Authorized Product

Performance and

Fee Report

$250, per Business Day, after the 10th

Business Day, until received by the

Department.

66 3.13.4 100% Select One $ -

65 3.13.3 100% Select One

$ - 67 3.13.5 100% Select One

DMS-24/25-199 Page 18 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Reporting

Requirements

Quarterly

Performance

Measures and

Deliverables Report

$250, per Business Day, after the 10th

Business Day, until received by the

Department.

Reporting

Requirements

Quarterly

Reconciliation

Report

$250, per Business Day, after the 10th

Business Day, until received by the

Department.

70 3.13.8

Reporting

Requirements

Quarterly Per

Member Fee

Assessment Report

100%

$250, per Business Day, after the 10th

Business Day, until received by the

Department.

Select One $ -

68 3.13.6 100% Select One $ -

$ - 69 3.13.7 100% Select One

DMS-24/25-199 Page 19 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Reporting

Requirements

Annual SUSORP and SMSOAP

Report

$500, per Business Day, after the 10th

Business Day, until received by the

Department.

72 3.13.11 Ad-hoc Report 100%

$100, per Business Day, after the required date identified by the

Department, until received by the

Department.

Select One $ -

73 3.14

Annual

Administrative

Review

100% $15,000, per occurrence, for no annual review.

Select One $ -

Transition Plans

Proposed End of

Contract Transition

Plan

71 3.13.9 100% Select One $ -

$ - 74 4.1.1 100% $1,000, per Business Day, after the 90

DMS-24/25-199 Page 20 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Transition Plans

Revised End of

Contract Transition

Plan

Transition Plans

Final End of

Service Transition

Plan

Deliverables

Non-acceptance/Cure

78 6.4 Performance

Measures 100% $250, per Business Day, if not timely submitted by the close of business the following Business Day after the request.

Select One $ -

75 4.1.2 100% $5,000, per occurrence, if not timely submitted.

Select One $ -

76 4.1.3 100% $1,000, per Business Day, after the 45

Select One $ -

77 5.3.2 100% $1,000, per Business Day, after the 10

Business Day, until received by the

DMS-24/25-199 Page 21 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

79 11.4 Notification of

Breach of Security 100%

$1,000, per Business Day, for each

Business Day, beyond the event date, until notice is received by the Department.

Select One $ -

80 11.5 Remedial

Measures 100%

$1,000, per Business Day, for each

Business Day, beyond the event date, until received by the Department.

Select One $ -

Indemnification

(Breach of

Warranty Security)

Indemnification

82 11.6 100%

$1,000, per Business Day, for each

Business Day, beyond the annual date, until list of individuals affected is received by the Department annually.

Select One

81 11.6 100%

$1,000, per Business Day, for each

Business Day, beyond the event date, until list of individuals affected or potentially affected is received by the

Department.

Select One

DMS-24/25-199 Page 22 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

(Breach of

Warranty Security)

83 11.7 Annual Certification 100%

$1,000, per Business Day, for each

Business Day, beyond December 31 st until received by the Department.

Select One $ -

Contract

Document

Background

Screening, Record

Retention, and

Warranty of

Security

Section 15.3

82 11.6 100%

$1,000, per Business Day, for each

Business Day, beyond the annual date, until list of individuals affected is received by the Department annually.

Select One $ -

84 Refresh Screening 100% $500, per occurrence, if not timely submitted.

DMS-24/25-199 Page 23 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Contract

Document

Background

Screening, Record

Retention, and

Warranty of

Security

Section

15.4.5

Contract

Document

Background

Screening, Record

Retention, and

Warranty of

Security

Section

15.4.6

Initial Warrant of

Security 100%

$500, per occurrence, if not timely submitted.

Select One $ -

$ - 86 Annual Warrant of

Security 100%

$500, per occurrence, if not timely submitted.

DMS-24/25-199 Page 24 of 25 PERFORMANCE MEASURES

NOTES:

A. The performance measure description is limited in detail in this document. The Service Provider must refer to Attachment B – Statement of Work reference for complete details.

B. The financial consequence for noncompliance shall be paid to the Department with its corresponding report (see, Attachment B – Statement of Work, Section 3.13, Reporting Requirements).

For example: Where applicable, a financial consequence is assessed by the Calendar Day, Business Day or per occurrence. The applicable performance measure is reported quarterly. The Service Provider shall pay the Department a financial consequence grand total for the applicable performance measure with its quarterly report.

C. Where there’s no applicable reporting requirement for a performance measure, the financial consequence grand total shall be paid quarterly.

D. See Attachment B - Statement of Work, Section 6, for Attachment H reporting requirements details.

NO.

SCOPE OF

WORK

REFERENCE

PERFORMANCE

MEASURE

REQUIRED

SERVICE

LEVEL

PERFORMANCE MEASURE FREQUENCY

AND

FINANCIAL CONSEQUENCE FOR

NONCOMPLIANCE

PERFORMANCE

MEASURE

STATUS

(MET/NOT MET)

PROVIDER

SERVICE LEVEL

(PERCENTAGE)

NUMBER OF

OCCURENCES

DURING THE

REPORTING

PERIOD

DELINQUENT DAYS

UNTIL MEASURE WAS

MET

FINANCIAL

CONSEQUENCE

ASSESSED

Contract

Document

Background

Screening, Record

Retention, and

Warranty of

Security

Section

15.4.7

Contract

Document $1,000 per occurrence.

Section

$250 per Business Day, if not received after requested date, until received by the Department.

23.3

Supplemental

Warrant of Security 100%

$500, per occurrence, if not timely submitted.

Select One

TOTAL FINANCIAL CONSEQUENCE ASSESSED $ -

Corrective Action

Plan 100% Select One $ -

DMS-24/25-199 Page 25 of 25 PERFORMANCE MEASURES