REQUEST FOR PROPOSALRFP No. 26 – HR - 01

BROKER SERVICES, MEDICAL, DENTAL, VISION, FIREFIGHTER CANCER, AND LIFE INSURANCE BENEFITS

Mary Mearsheimer, Procurement Agent

TABLE OF CONTENTS

CITY OF HOLLY HILL, FLORIDA

RFP BID# 26 – HR - 01

SECTION 1 — INVITATION TO PROPOSE & GENERAL INFORMATION

SECTION 2 — BACKGROUND / CURRENT BENEFIT PROGRAM

SECTION 3 — PURPOSE / OBJECTIVE

3.0 Purpose / Objective Page 4

SECTION 4.0 — SCOPE OF SERVICES

SECTION 5 PROPOSAL INSTRUCTIONS & EVALUATION CRITERIA

SECTION 6 — REQUIRED FORMS, TERMS & CONDITIONS

PROFESSIONAL SERVICES AGREEMENT

Professional Services Agreement- Broker Services, Medical, Dental, Vision,

REQUEST FOR PROPOSAL

CITY OF HOLLY HILL, FLORIDA

RFP # 26 –HR- 01

SECTION 1 — INVITATION TO PROPOSE

1.1 Public Notice

The City of Holly Hill, Florida (“City”) is accepting sealed proposals from qualified firms to provide Broker Services for Medical, Dental, Vision, Firefighter Cancer, and Life Insurance Benefits.

1.2 Proposal Submission Deadline

Proposals must be submitted by 3:00 PM EST on April 8th , 2026. See Section 1.7 for complete submission instructions

1.3 Pre-Proposal Conference: (Non-Mandatory)

Date/Time: March 18, 2026, at 3:00 PM Location: Commission Chambers, City Hall, 1065 Ridgewood Avenue, Holly Hill, FL 32117

1.4 RFP Documents & Addenda

Complete RFP documents are available electronically via VendorLink at www.myvendorlink.com.

Any addenda will be posted exclusively on VendorLink. Prior to submitting a proposal, proposers must review all issued addenda and confirm receipt by listing and acknowledging each addendum in Section 6.1 of the proposal.

1.5 Questions / Contact Information

All questions must be submitted in writing by 5:00 PM EST on April 2rd , 2026 to:

Mary Mearsheimer – mmearsheimer@hollyhillfl.org Addenda or clarifications will be posted on VendorLink; proposers must check for updates prior to submission.

1.6 Lobbying / Unauthorized Communications (Cone of Silence)

To ensure a fair evaluation:

· Proposers and their representatives must not contact City officials or staff regarding this RFP except through the designated contact listed above

1.11 Prohibition on Solicitation of Pricing

Proposers shall not contact any insurance carriers, third-party administrators, or other vendors to request quotes, pricing, or any other information specific to the City of Holly Hill prior to the award of a contract. Any such requests made on behalf of the City before a broker has been officially selected may result in disqualification from consideration.

Proposers may, however, provide illustrative pricing examples or general market information based on publicly available data or anonymized case studies, provided that such information is not represented as pricing for the City of Holly Hill.

The City has not authorized any proposer to approach insurance markets on its behalf as part of this solicitation.

1.7 Proposal Submission Instructions

Submit one (1) signed original and one (1) electronic copy (USB) in a sealed envelope clearly labeled: “RFP #26-HR-01 — Broker Services, Medical, Dental, Vision, Firefighter Cancer, and Life Insurance Benefits.”

Addressed to:

City Clerk City of Holly Hill 1065 Ridgewood Avenue Holly Hill, FL 32117-2898 Deadline: 3:00 PM, April 8th , 2026. Late submissions will not be considered.

1.8 Legal Disclaimer Items

The City is not responsible for delivery delays.

The City reserves the right to accept or reject any proposal, waive minor irregularities, and award the contract in the best interest of the City.

Proposers must comply with all applicable laws, including submitting the Public Entity Crimes Statement (see Section 6.5). The City reserves the right to accept or reject any proposal.

1.9 Notice of Award

The City will provide written notice of award to the selected proposer after completion of the evaluation process and approval by the City Commission, if required.

1.10 Protest Procedures

Any protest or appeal shall follow the City of Holly Hill Purchasing Policies and Procedures, adopted by Resolution No. 2018-30, as may be amended. Copies are available from the City Clerk.

BROKER SERVICES, MEDICAL, DENTAL, VISION, FIREFIGHTER CANCER, AND LIFE INSURANCE BENEFITS

RFP # 26-HR-01

IMPORTANT DATES

ACTIVITY

DATE

LOCATION

RFP ISSUED

MONDAY

March 9, 2026

VENDORLINK

PRE-PROPOSAL CONFERENCE

WEDNESDAY

MARCH 18, 2026

3:00 P.M.

COMMISSION CHAMBERS

1065 RIDGEWOOD AVE

HOLLY HILL, FL 32117

QUESTIONS END DATE

FRIDAY

APRIL 2, 2026

5:00 P.M.

mmearsheimer@hollyhillfl.org

PROPOSAL OPENING

(All Responses in by 3:00 P.M.)

WEDNESDAY

April 8, 2026 3:00 P.M.

COMMISSION CHAMBERS

PROPOSER PRESENTATION TO THE CITY COMMISSION

Each proposer will have up to 10 minutes to present, followed by 5 minutes for questions from the Commission.

TUESDAY

April 28, 2026 6:00 P.M.

COMMISSION CHAMBERS

AWARD BY CITY COMMISSION

(Tentative Date)

TUESDAY

May 12, 2026 6:00 P.M.

COMMISSION CHAMBERS

COVERAGE BEGINS

JULY 1, 2026

SECTION 2.0 — BACKGROUND / CURRENT BENEFIT PROGRAM

City Overview: The City of Holly Hill is a municipal government located in east-central Florida along the Halifax River.

Current Benefits Program: Fully insured employee benefits are provided through Florida Health Care Plans.

Current Enrollment For Medical Coverage: (March 2026)

· Employees enrolled in medical: 109

· Eligible dependents: 14

· Retirees: 4

· Non-union employees: 37

Coverage Funding

· Employee-only coverage: Fully paid by the City

· Spouses, dependents, and retirees: Coverage available at additional cost

Eligibility

· Full-time employees receive City-paid coverage. Coverage for spouses, dependents, and retirees is available at the employee’s expense. New hire insurance is effective the first of the month following 30 days of employment. Coverage terminates on the last day of the month of employment termination.

2.1 Current benefit offerings include:

Medical: Health Savings Account (HSA) plan available to all employees.

Life Insurance: Basic Life with AD&D (Employer Paid) through USAble; voluntary and dependent life and AD&D coverage fully employee-paid.

· Retiree Participation: Currently, 47 retirees participate in life insurance coverage, paying their own premiums.

Firefighter Cancer Coverage: City-paid policy through Chubb (firefighters only).

Dental & Vision: PPO plans (MetLife and EyeMed), fully employee-paid.

SECTION 3.0 – PURPOSE / OBJECTIVE

The City of Holly Hill is soliciting proposals from qualified firms licensed in the State of Florida to provide broker services for its employee and retiree benefits program, including Medical, Dental, Vision, Firefighter Cancer, and Life insurance.

The selected broker, as the City’s Agent of Record, will:

• Place, manage, and evaluate benefit programs.

• Review current plans and advise on design, cost, and funding strategies.

• Ensure compliance with federal, state, and local regulations.

• Assist with employee and retiree enrollment, education, and claims support.

• Identify opportunities for plan optimization and recommend innovative programs.

• Provide guidance on industry trends to support comprehensive, cost-effective benefits.

The City seeks a broker capable of delivering high-quality, accessible services to employees and retirees, while maintaining comprehensive, cost-effective benefits

SECTION 4.0 SCOPE OF SERVICES

4.1 Broker Role and Responsibilities

The selected firm shall serve as the City of Holly Hill’s Agent of Record for Medical, Dental, Vision, Firefighter Cancer, and Life insurance benefits. The Broker shall provide comprehensive consulting, marketing, placement, implementation, and ongoing service and compliance support for the City’s employee and retiree benefits program. Responsibilities include:

· Acting as the City’s official liaison with all insurance carriers.

· Monitoring carrier performance and service levels.

· Reviewing current plans, analyzing claims experience and utilization trends.

· Providing renewal projections, financial impact analysis, and plan design recommendations.

· Negotiating renewal rates and plan terms with carriers.

· Advising on cost containment strategies, funding considerations, and market alternatives.

· Advocating on behalf of the City in resolving administrative or service issues.

· Disclosing all forms of compensation received in connection with the City’s benefit plans.

4.2 Enrollment & Implementation Support

The Broker shall assist with all aspects of employee and retiree enrollment and plan implementation:

· Developing a written implementation timeline and enrollment schedule, in coordination with the City’s HR department.

· Provide enrollment materials, summaries of benefits, and required notices.

· Conduct on-site and/or virtual employee meetings as requested.

· Support eligibility data transmission, file management, and timely distribution of ID cards and plan documents.

· Provide an online platform for individual employee enrollment.

· Assist with plan transitions or new offerings, if applicable.

4.3 Ongoing Plan Administration

The Broker shall provide continuous support and advocacy throughout the plan year:

· Respond to employee benefit inquiries and claims issues.

· Provide claims advocacy and assist in resolving coverage disputes.

· Advise on renewals, amendments, or plan modifications.

· Attend meetings with City staff as requested.

4.4 Benefit Proposal Submission Timeline

· Contractor must submit all proposed benefit plan designs, rates, and supporting documentation to the City by October 1 of the year preceding the coverage effective date. This firm, non-negotiable deadline ensures the City Commission can review and approve plans at their first October meeting in time for the November 1 open enrollment.

4.5 Regulatory Compliance & Reporting

The Broker shall ensure the City’s benefits programs comply with applicable laws and regulations and provide reporting as required:

· Provide guidance on federal and state regulations, including:

· Affordable Care Act (ACA)

· COBRA

· HIPAA

· IRS Section 125

· Medicare Secondary Payer rules

· Florida insurance regulations

· Florida Firefighter Cancer Presumption requirements

· Serve as the City’s Section 125 Plan administrator.

· Notify the City of regulatory changes affecting benefit programs and assist with implementation.

· Provide reporting and analysis, including:

· Annual renewal analysis

· Claims and utilization summaries

· Financial and trend analysis

· Enrollment reporting

· Sample reports shall be included in the proposal.

4.6 Wellness Support

· Review wellness initiatives available through carriers and provide recommendations for programming, participation incentives, and employee engagement.

· Identify any associated costs clearly.

4.7 Firefighter Cancer Coverage

· Monitor and review coverage to ensure compliance with Florida statutory requirements.

· Provide ongoing service and claims support for firefighter participants.

· Broker shall stay current with Florida Firefighter Cancer Presumption law and provide ongoing compliance support

4.8 Separability of Coverages

· The City reserves the right to purchase benefit coverages individually or collectively.

· Proposers must clearly indicate any coverages that must be bundled and provide a breakdown of compensation associated with each line of coverage.

4.9 Implementation Services

If plan changes occur, the Broker shall:

Develop a written implementation timeline in coordination with the City’s HR department.

Coordinate enrollment scheduling with HR to ensure smooth participation.

Ensure timely distribution of ID cards and plan documents.

Support eligibility data transmission and enrollment file management.

Provide an online platform for individual employee enrollment.

Support transition of coverage, if applicable.

SECTION 5 — PROPOSAL INSTRUCTIONS & EVALUATION CRITERIA

5.1 Proposal Organization

Proposals must be organized in a binder and electronic format, submitted in the following order. Page limits are provided for guidance:

1. Cover Letter (2-page limit)

· Include the name, address, email, and phone number of the contact person for this proposal.

· Confirm that your firm meets the minimum qualifications outlined in Section 6.

· Provide the number of Florida offices, Florida-based employees, and public entities served.

· Include any additional relevant information demonstrating your firm’s qualifications.

2. Company Overview (2-page limit)

1. Briefly describe your firm, including size, structure, resources, and financial capacity.

2. Provide experience with similar public-sector benefits programs in the last three years.

3. Scope of Services

· Respond to all requested services and questions in detail.

4. Key Personnel (3-page limit)

· Provide an organizational chart (1 page) showing the members of your servicing team dedicated to the City.

· Include general information on key personnel, including experience, education, and relevant background.

· Indicate the average tenure of assigned team members with the firm.

5. Premiums and Fees (9-page limit)

· Provide a summary indicating any coverages not included, deviations from requested coverages, and all brokerage or agent fees (flat or percentage-based).

· Include a side-by-side comparison of current and proposed health, dental, vision, firefighter cancer, and life insurance plans and rates, clearly showing employee, dependent, and retiree costs.

6. Other Required Information

· Copies of all applicable licenses and Errors & Omissions certificates.

· Proof that your firm has been successfully operating in Florida for at least five (5) consecutive years as of the proposal due date.

· Most recent audited financial statement (issued by a CPA within 18 months) demonstrating financial viability.

· Note: The City reserves the right to review financial records related only to the awarded contract to confirm the proposer’s ability to meet contract obligations.

5.2 Minimum Qualifications of Proposed Insurers

All insurers proposed by the Broker must meet the following minimum standards:

1. A.M. Best Rating

· Insurers must maintain an A or higher rating from A.M. Best & Company.

2. Alternative for Unrated Insurers

· If an insurer is not rated by A.M. Best, the proposer must demonstrate:

1. Successful operation in Florida for at least five (5) consecutive years.

2. Submission of a recent audited financial statement with an unqualified opinion.

3. The City’s right to review financial records related only to the awarded contract.

3. Financial Strength

· All proposed insurers must demonstrate financial capacity to perform under the proposed coverage, either through ratings, audited financials, or both.

5.3 Proposal Instructions / Evaluation

Proposals must address the City’s right to purchase coverages individually or as a bundled package Vendors must provide a clear breakdown of premiums for each coverage and indicate any mandatory bundling. Any differences in premiums when purchased separately should be explicitly stated.

5.4 Contract Term

The initial term of this Contract shall be for a period of 1 year. The Agency reserves the right to renew the Contract for up to 3 additional one-year renewal terms, subject to satisfactory performance and availability of funds.

Proposers must submit a price schedule that includes pricing for each year of the initial term and each potential renewal year. Pricing for renewal years shall be clearly identified and itemized.

Failure to provide pricing for all years may result in the proposal being deemed non-responsive.

For evaluation purposes, the Agency will consider the total cost of the proposal, including all renewal years, in accordance with Section 287.057, Florida Statutes.

5.5 Invoices & Payment Terms

· Invoices must be submitted after delivery of policies or contracts conforming to the awarded proposal.

· Invoices must detail all related costs.

· Payments are governed by the Local Government Prompt Payment Act (Sections 218.70 – 218.80, Florida Statutes).

5.6 Proposal Submittal Instructions

•Proposers shall bear all costs incurred in preparing and submitting a proposal, including presentations or interviews.

• Proposals may be withdrawn in writing before the submission deadline. After the deadline and until a contract is executed, proposals shall remain firm and irrevocable.

• Submit one (1) signed original and one (1) electronic copy (USB) to:

City Clerk – Valerie Manning City of Holly Hill 1065 Ridgewood Avenue Holly Hill, FL 32117

• Clearly mark the envelope: “RFP #26-HR-01 — Broker Services, Medical, Dental, Vision, Firefighter Cancer, and Life Insurance Benefits.”

• Proposals must be received by 3:00 PM, April 8, 2026. Late submissions will not be accepted.

5.7 Execution of Proposal / Signature Requirements

The proposal must be signed by an authorized representative of the firm, certifying that all information is accurate and that the proposer is authorized to bind the firm.

• Consortiums or joint ventures are allowed, but all contractual responsibility must reside with a single firm or legal entity.

5.8 Evaluation Process and Criteria

Proposals will be evaluated by an Evaluation Committee in accordance with the criteria outlined below. The Evaluation Committee will review and score all responsive proposals, and the results of the evaluation will be tabulated.

Following the evaluation process, the Evaluation Committee will provide a recommendation to the City Commission.

City Commission Presentations All proposers are required to attend and present to the City Commission on April 28, 2026, at 6:00 p.m. at City Hall. Proposers should ensure that appropriate representatives are present and prepared to respond to questions from the City Commission.

Each proposer will be allotted up to ten (10) minutes to present their proposal, followed by up to five (5) minutes for questions from the City Commission.

Presentations are intended to provide the City Commission with additional information prior to consideration of the Evaluation Committee’s recommendation.

Failure of a proposer to attend the presentation may result in the proposal being deemed non-responsive.

The following criteria will guide the Evaluation Committee’s scoring:

Qualifications of Firm –

1. Demonstrates strong knowledge in providing, structuring, and administering municipal employee benefit programs. (0–5 pts)

2. Shows a proven history of successfully delivering municipal insurance coverages and benefit plan administration. (0–10 pts)

3. Firm size, structure, and financial capacity adequate to serve a municipal client. (0–5 pts) Total Eligible Points: 20 pts

Experience of Team

1. Key team members have direct experience providing municipal employee benefit programs. (0–10 pts)

2. Team qualifications and expertise sufficient to manage the city’s benefit program effectively. (0–5 pts) Total Eligible Points: 15 pts

Responsiveness to Scope & Technology (20 Points)

1. Demonstrates understanding of the full scope of services requested in the RFP. (0–10 pts)

2. Ability to meet all principal areas defined in the RFP Scope of Services. (0–5 pts)

3. Technology and administrative capabilities (portals, reporting, enrollment support). (0–5 pts) Total Eligible Points: 20 pts

Plan Design, Cost & Provider Disruption

1. Proven ability to control costs, optimize plan structure, and secure competitive rates. (0–20 pts)

2. Provides competitive pricing for both current and alternate plan designs. (0–15 pts) Total Eligible Points: 35 pts

References – Quality of public-sector client references

1. Public-sector client references demonstrating successful delivery of similar services. (0–10 pts) Total Eligible Points: 10 pts

The Evaluation Committee will provide a recommendation to the City Commission; however, the City Commission reserves the right to accept, reject, or modify the recommendation and to award the contract in the best interest of the City.

Additional Rights Reserved by the City:

· Use consultants, specialists, or peer review groups for evaluation.

· Modify, extend, or cancel the RFP.

· Negotiate or conduct interviews/presentations with proposers.

· Accept or reject proposals in whole or part, waive minor deficiencies, and limit contract services.

· Verify proposer information and disqualify false submissions.

5.10 Required Disclosure

The City may reject proposals from any Proposer whose current or former executives or owners have convictions, regulatory sanctions, or fraud/financial misrepresentation. By submitting a proposal, the Proposer accepts this discretion.

END OF PAGE

SECTION 6 — REQUIRED FORMS, TERMS & CONDITIONS

6.1 Proposal Declaration & Authorization Certification

The undersigned, as Proposer, declares and certifies that:

1. The only persons interested in this proposal as principals are those named herein; no other persons have any interest in this proposal.

2. The proposal is submitted in good faith, without collusion, fraud, or misrepresentation.

3. All information in the proposal, including Cost Proposal, Timeline, Qualifications, and References, is complete and accurate.

4. The proposer agrees to all terms, conditions, and requirements of this RFP.

5. Any addenda issued for this RFP have been considered in preparing this proposal.

Addendum No. ______ Dated: __________ Addendum No. ______ Dated: __________

6. This proposal is valid for 120 days from the submission date.

7. The undersigned is authorized to submit this proposal on behalf of the Proposer and certifies that the statements made herein are true and correct.

Authorized Representative: _______________________________

Title/Position: ___________________________________________

Signature: ______________________________________________

Date: __________________________________________________

Email: ________________________________________________

Phone: ________________________________________________

SECTION 6.2 QUESTIONNAIRE

Where applicable, please check the appropriate response:

Q1. Is the Agent of Record properly licensed by the State of Florida and currently in good standing with the Florida Department of Insurance and all other applicable regulatory entities to conduct business in the state and provide the requested services?

A1: ☐ Yes ☐ No Q2. Does the Agent of Record have a minimum of five (5) years of experience providing governmental insurance services?

A2: ☐ Yes ☐ No Q3. Has the Agent of Record served municipal clients within the last ten (10) years?

A3: ☐ Yes ☐ No If yes, please provide a list of five (5) clients below:

Q4. Can the Agent of Record provide reference contacts from municipal clients serviced within the past ten (10) years?

A4: ☐ Yes ☐ No If yes, please list the entity name(s), contact name(s), and contact phone number(s) below.

NOTE: Contacts listed will be verified.

Q5. As an Agent of Record, do you have experience in benefit seminar planning?

A5: ☐ Yes ☐ No Q6. As an Agent of Record, do you fully understand the Scope of Services outlined in this RFP?

A6: ☐ Yes ☐ No

Q7. As an Agent of Record, do you have experience with the following types of insurance and services?

Q8. Has the Agent of Record or any member of your agency ever been indicted, convicted, pled guilty, or pled no contest to the commission of a felony?

A8: ☐ Yes ☐ No Q9. As an Agent of Record, does your agency maintain a minimum of five million dollars ($5,000,000) in professional errors and omissions liability insurance?

A9: ☐ Yes ☐ No If not, what is the current limit? ___________________ Q10. Has the Agent of Record or any member of your agency ever been involved in any claim or litigation with any Federal, State, or Local Government entity, or with a private entity?

A10: ☐ Yes ☐ No Q11. As an Agent of Record, does your agency hold preferred status with any insurance carriers? If so, please list the carriers and your level of status:

A11. Carrier: Preferred Status with Carrier:

Q12. Who will be the City’s principal contact(s) for this project? Provide name, title, and a brief description of the individual(s) experience in brokering benefit coverage.

A12. ________________________________________________________________________________

6.3 Payment of Taxes

Contractor is responsible for all applicable taxes on their own operations, including payroll, income, and corporate taxes.

The City is exempt from sales, use, or similar taxes; these should not be included in the proposal.

6.4 Prohibition of Gifts and Gratuities

In accordance with Chapter 112, Part III, Florida Statutes:

· Contractors, proposers, and representatives shall not offer or provide, directly or indirectly, any gift, gratuity, favor, loan, service, or item of value to any City employee or official in connection with this RFP or resulting contract.

6.5 Insurance Requirements

General Requirement

· The Contractor shall, at its sole expense, procure and maintain insurance coverage for the duration of this Agreement (including any renewal periods) with insurers authorized to do business in Florida and rated A- or higher by A.M. Best.

· Proof of insurance shall be provided prior to contract execution and upon request during the term of the contract.

Required Coverage

1. Commercial General Liability (CGL)

· Including products/completed operations

· Minimum limits:

· $500,000 per occurrence

· $1,000,000 aggregate

· $1,000,000 combined single limit per accident

2. Workers’ Compensation

· As required by Florida law

· Including Employer’s Liability with minimum limits:

· $100,000 each accident

· $100,000 disease – each employee

· $500,000 disease – policy limit

3. Professional Liability (Errors & Omissions)

· Minimum limits: $5,000,000 per claim and aggregate

3. Certificate of Insurance

· The Contractor shall provide a Certificate of Insurance evidencing all required coverages prior to execution of this Agreement.

· Certificates must name the City of Holly Hill as an additional insured for CGL coverage.

· Contractor shall provide updated Certificates upon renewal or upon request.

4. Insurance Conditions

· The City shall not pay premiums, deductibles, or assessments for any required insurance.

· Coverage shall remain in effect for the duration of this Agreement.

· Contractor shall immediately notify the City of any material change, cancellation, or non-renewal of coverage.

6.6 Indemnification

Contractor shall indemnify, defend, and hold harmless the City, its officials, officers, and employees from claims, damages, losses, liabilities, costs, and expenses, including attorney’s fees, arising from Contractor’s negligent acts or omissions under the contract.

This obligation survives contract termination or expiration.

Nothing in this provision waives the City’s sovereign immunity under Florida law (Section 768.28, F.S.).

END OF PAGE

6.7 SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES This sworn statement is submitted with Bid, Proposal or Contract No. _____________ for

This sworn statement is submitted by ___________________________________whose business address is _______________________________________________________and (if applicable) its Federal Employer Identification Number (FEIN) is__________________. (If the entity has no

FEIN, include the Social Security Number of the individual signing this sworn statement:

My name is _____________________________ and my relationship to the entity named above is

I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.

I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.

I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means:

1. A predecessor or successor of a person convicted of a public entity crime: or

2. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be prima facie that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate.

I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity.

Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Please indicate which statement applies).

______Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members or agents who are active in management of the entity, nor any affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July 1, 1989.

______ The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989, AND (Please indicate which additional statement applies.)

______ There has been a proceeding concerning the conviction before a hearing officer of the State of Florida, Division of Administrative Hearings. The final order entered by the hearing officer did not place the person or affiliate on the convicted vendor list. (Please attach a copy of the final order.)

_______ The person or affiliate was placed on the convicted vendor list. There has been a subsequent proceeding before a hearing officer of the State of Florida, Division of Administrative Hearings. The final order entered by the hearing officer determined that it was in the public interest to remove the person or affiliate from the convicted vendor list. (Please attach a copy of the final order).

(Signature)__________________________________________ Date:______________________

State of________________________________ County of ______________________________.

PERSONALLY, APPEARED BEFORE ME, the undersigned authority, ____________________ who, after first being sworn by me, affixed her/his signature in the space provided above on this

_________day of______________, 20____.

Notary Public My Commission Expires:____________________________

6.8 CERTIFICATION OF INTEGRITY- Anti-Collusion & Conflict of Interest Statement

ANTI-COLLUSION:

By signing this form, the undersigned certifies that this proposal is submitted without any understanding, agreement, or connection with any other person, corporation, or firm submitting a proposal for the same purpose. The proposal is in all respects fair, without collusion or fraud, and reflects the Proposer’s independent judgment.

CONFLICT OF INTEREST:

The undersigned further certifies that, to the best of their knowledge, neither the Proposer nor any of its officers, directors, employees, or agents have any financial, personal, or other interests that could create a conflict of interest in performing the services requested by the City of Holly Hill. The Proposer agrees to promptly disclose any potential conflicts that may arise during the course of this engagement.

By signing below, the Proposer acknowledges acceptance of the terms and conditions of the RFP specifications and agrees that the proposal will remain valid for one hundred and twenty (120) days from the proposal opening date.

Name of Firm: ____________________________________________________________

Authorized Signature: ______________________________________________________

Printed Name & Title: _____________________________________________________

Address: ________________________________________________________________

City, State, ZIP: ________________________________________________________

Telephone: ______________________________________________________________

Date: ___________________________________________________________________

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6.9 COMPLIANCE WITH THE PUBLIC RECORDS LAW

Project Number: RFP # 26-HR-01

Upon award recommendation or ten (10) days after opening, submittals become "public records" and shall be subject to public disclosure consistent with Chapter 119, Florida Statutes. Proposers must invoke the exemptions to disclosure provided by law in response to the solicitation and must identify the data or other materials to be protected, and must state the reasons why such exclusion from public disclosure is necessary. The submission of a proposal authorizes release of your firm’s credit data to the CITY.

If the company submits information exempt from public disclosure, the company must identify with specificity which pages/paragraphs of their bid/proposal package are exempt from the Public Records Act, identifying the specific exemption section that applies to each. The protected information must be submitted to the CITY in a separate envelope marked accordingly.

IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT Valerie Manning, City Clerk 386-248-9441 vmanning@hollyhillfl.org 1065 Ridgewood Ave Holly Hill, FL 32117

A provision that requires the contractor to comply with public records laws, specifically to:

1. Keep and maintain public records required by the public agency to perform the service.

2. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law.

3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the contractor does not transfer the records to the public agency.

4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the contractor or keep and maintain public records required by the public agency to perform the service. If the contractor transfers all public records to the public agency upon completion of the contract, the contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the contractor keeps and maintains public records upon completion of the contract, the contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency.

By submitting a response to this solicitation, the company agrees to defend the CITY in the event we are forced to litigate the public records status of the company’s documents.

Company Name: __________________________________________________

Authorized representative (printed): ___________________________________

Authorized representative (signature): __________________________________

Date: _____________________ 2 | Page

6.10 VENDOR E-VERIFY AFFIDAVIT BID NO. 26-HR-01

IN ACCORDANCE WITH SECTION 448.095, FLORIDA STATUTES

I, the undersigned, hereby certify that ____________________________________ (Insert contractor company name) does not employ, contract with, or subcontract with an unauthorized alien, and is otherwise in full compliance with Section 448.095, Florida Statutes.

I acknowledge that it is my responsibility to ensure full compliance with Section 448.095, Florida Statues. I understand that enrollment in the E-Verify system for employers can be done at www.e-verify.gov

A true and correct copy of ___________________________________ (Insert contractor company name) proof of registration in the E-Verify system is attached to this Affidavit (print out the first 2 pages and send along with this form.)

By affixing my signature below, I hereby affirm that I am duly authorized to bind the company referenced herein and I will comply with all applicable E-Verify requirements.

(Print or Type Name, Title) (Signature of Affiant)

(Federal Employer ID Number – F (E-Verify Number)

STATE OF FLORIDA

COUNTY OF _______________________________

The foregoing instrument was acknowledged before _____ me by means of physical presence or ____ online Notarization, this _______ day of ___________________, 20______, By _________________________________as __________________________of On behalf of the company. He/she is personally known to me or has produced __________________________ (Type of ID) as identification.

Notary Public, State of Florida at Large Printed, typed or stamped date, commission and expiration of commission.

PROFESSIONAL SERVICES AGREEMENT

BROKER SERVICES, MEDICAL, DENTAL, VISION, FIREFIGHTER CANCER, AND LIFE INSURANCE BENEFITS

RFP # 26-HR-01

This Professional Services Agreement is entered into this ___ day of ________, 20______

(“Effective Date”), by and between the City of Holly Hill, Florida, a Florida municipal corporation (“City”), and ____________________________, a company organized under the laws of the State of __________ (“Contractor”). The City and Contractor may be referred to individually as a “Party” and collectively as the “Parties

ARTICLE 1 – SCOPE OF SERVICES

Contractor shall provide broker services for City’s employee and retiree benefits, including:

· Agent of Record duties (Medical, Dental, Vision, Firefighter Cancer, Life insurance.

· Review of current benefits, plan design, and cost strategies.

· Renewal negotiation and carrier liaison.

· Enrollment support, employee education, and communications.

· Provide an online platform for individual employee enrollment.

· Coordinate with HR on enrollment schedule.

· Claims advocacy and regulatory compliance guidance (ACA, COBRA, HIPAA, Section 125, Firefighter Cancer law).

· Ongoing reporting, trend analysis, and wellness recommendations.

· Contractor acts as official liaison with carriers in the City’s best interest.

· Changes to scope require written authorization from the City Manager.

· Contractor must submit all proposed benefit plan designs, rates, and supporting documentation to the City by October 1 of the year preceding the coverage effective date to allow the City Commission to approve plans at their first October meeting for the November 1 open enrollment period. This is a firm and non-negotiable deadline.

ARTICLE 2 – CONTRACT TERM/COMPLETION TIME

· The initial term of this Contract shall be for a period of 2 years. The City reserves the right to renew the Contract for up to 3 additional one-year renewal terms, subject to satisfactory performance and availability of funds.

· Proposers must submit a price schedule that includes pricing for each year of the initial term and each potential renewal year. Pricing for renewal years shall be clearly identified and itemized.

· Failure to provide pricing for all years may result in the proposal being deemed non-responsive.

ARTICLE 3 – COMPENSATION

· Contractor invoices for services provided; payment in accordance with the Local Government Prompt Payment Act (Sections 218.70–218.80, F.S.).

· Contractor must disclose all direct/indirect compensation (commissions, fees, benefits) related to City services.

· Invoice frequency and payment terms shall be mutually agreed and consistent with the proposal.

ARTICLE 4 – INDEPENDENT CONTRACTOR

· Contractor is an independent contractor and not an employee of the City. Contractor is solely responsible for personnel, taxes, and benefits.

ARTICLE 5 – INSURANCE

Contractor shall maintain insurance as required in RFP Section 6.5. At a minimum, this includes:

1. Commercial General Liability (CGL)

· Including products/completed operations

· Minimum limits:

· $500,000 per occurrence

· $1,000,000 aggregate

· $1,000,000 combined single limit per accident

2. Workers’ Compensation

· As required by Florida law

· Employer’s Liability minimum limits:

· $100,000 each accident

· $100,000 disease – each employee

· $500,000 disease – policy limit

3. Professional Liability (Errors & Omissions)

· Minimum limits: $5,000,000 per claim and aggregate

Additional Requirements:

· Contractor shall provide Certificates of Insurance prior to execution, naming the City of Holly Hill as additional insured for CGL coverage.

· Insurance shall remain in effect for the duration of the Agreement.

· Contractor shall immediately notify the City of any material change, cancellation, or non-renewal of coverage.

· The City shall not be responsible for premiums, deductibles, or assessments.

ARTICLE 6 – INDEMNIFICATION

Contractor indemnifies and holds harmless the City for claims, damages, or losses from negligent acts or omissions.

Does not waive City’s sovereign immunity.

Survives termination or expiration.

ARTICLE 7 – CONFIDENTIALITY & DATA SECURITY

Contractor must maintain confidentiality of all City and employee data.

All records must be secured and returned upon contract completion.

ARTICLE 8 – TERMINATION

8.1 Termination for Cause

Immediate termination if Contractor:

1. Fails to perform material obligations and does not cure within 10 business days.

2. Violates laws, regulations, or City policy.

3. Becomes insolvent or bankrupt.

8.2 Termination for Convenience

· City may terminate with thirty (30) days written notice.

8.3 Contractor Responsibilities Upon Termination

Continue services through termination date.

Deliver all records, including public records.

Cooperate for smooth transition to new broker.

8.4 Payment Upon Termination

· The City shall pay the Contractor only for services satisfactorily provided through the effective date of termination.

· No payment shall be made for future services unless specifically authorized in writing.

8.5 Survival

· Public Records, Confidentiality, Indemnification, and Data Security obligations survive termination.

ARTICLE 9 – ASSIGNMENT

· Contractor may not assign or transfer without City’s prior written consent.

ARTICLE 10 – PUBLIC RECORDS

The Contractor shall comply with Chapter 119, Florida Statutes, This obligation survives termination of the Agreement.

10.1 – PUBLIC RECORDS / FLORIDA SUNSHINE LAW

IF THE CONTRACTOR HAS QUESTIONS REGARDING THE

APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE

CONTRACTOR’S DUTY TO PROVIDE PUBLIC RECORDS RELATING

TO THIS CONTRACT, THE CONTRACTOR SHALL CONTACT THE

CUSTODIAN OF PUBLIC RECORDS:

City Clerk: Valerie Manning City of Holly Hill 1065 Ridgewood Avenue Holly Hill, Florida 32117 Phone: (386) 248-9441 Email: vmanning@hollyhillfl.org

10.2 Contractor Responsibilities

1. Keep and maintain public records required by the City to perform the services under this Agreement.

2. Upon request from the City’s custodian of public records, provide the City with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided by law.

3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the Agreement and following completion of the Agreement if the Contractor does not transfer the records to the City.

4. Upon completion of the Agreement, transfer, at no cost, to the City all public records in the possession of the Contractor, or keep and maintain public records required by the City to perform the services. If the Contractor transfers all public records to the City upon completion, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the City, upon request from the City’s custodian of public records, in a format compatible with the City’s information technology systems of the public agency.

ARTICLE 11 – GOVERNING LAW & VENUE

· Florida law governs.

· Venue: Volusia County, Florida.

ARTICLE 12 – FORCE MAJEURE

Neither Party shall be liable for delays caused by events beyond reasonable control (e.g., disasters, labor disputes, governmental actions, pandemics).

Affected Party shall notify the other promptly.

City may extend performance up to 60 days, after which it may terminate the Agreement if services have not resumed.

ARTICLE 13 – ENTIRE AGREEMENT

This Agreement, the RFP #26-HR-01, and the Contractor’s proposal constitute the entire agreement.

In case of conflict, this Agreement shall control.

SIGNATURES: IN WITNESS WHEREOF, the Parties have executed this Agreement as of the date first written above.

CITY OF HOLLY HILL, FLORIDA CONTRACTOR

By: _______________________________ By:______________________________________

Name: _____________________________ Name: ________________________________

Date:_____________________________Date:_______________________________________

ATTEST: __________________________

Valerie Manning (City Clerk) image2.png image1.wmf