Attachment J, Broker Information.pdf
PDF 76 KB Posted
- Attached to
- Government Crime Insurance
- Solicitation number
- ITB-17050
- Issued by
- Florida
About this file
Attachment J is a broker information form used by the Florida Department of Management Services for the Government Crime Insurance Invitation to Bid (ITB). The solicitation seeks to establish a single contract for government crime insurance to replace the current policy. The Department will make award to the lowest responsive and responsible bidder in accordance with Florida Statutes sections 287.057(1) and 287.022, reserving the right to make no award if determined to be in the State's best interest. The procurement officer is Jill Soderberg, Division of State Purchasing, Florida Department of Management Services, located at 4050 Esplanade Way, Suite 360.5Z, Tallahassee, FL 32399-0950, with contact information at 850-488-7996 or jill.soderberg@dms.fl.gov. Interested vendors must submit responses through the MyFloridaMarketPlace Sourcing Event via the SAP Business Network and are responsible for monitoring the Vendor Information Portal (VIP) throughout the procurement process.
Attachment J requires bidders to identify a broker and provide the Federal Employer Identification Number (FEIN) along with designating the person responsible for administering the insurance policy if award is made. Bidders must include the policy administrator's name, title, street address, email address, phone number(s), fax number, and emergency contact number. If the broker's bid contact differs from the policy administrator, bidders must provide identical information for that alternate contact person. Protests concerning the agency decision must be filed timely with the Agency Clerk in accordance with section 120.57(3), Florida Statutes, with failure to file within the prescribed timeframe or post required security constituting a waiver of proceedings under chapter 120, Florida Statutes.
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Text version
Attachment J Broker Information
Broker:
FEIN:
Bid/Insurance Policy Administration
Please identify the person who is to be responsible for administering the Insurance Policy on your behalf if award is made and include an emergency contact phone number.
Name:
Title:
Street Address:
E-mail Address:
Phone Number(s):
Fax Number:
Emergency Number:
If the person responsible for answering questions about the Broker’s Bid is different from the person identified above, please provide the same information for the person responsible for answering questions about the Broker’s Bid.
Name:
Title:
Street Address:
E-mail Address:
Phone Number(s):
Fax Number:
File details come from the government source that posted it. Updated .