S-44000-00009689_Att E_Price Proposal Form.docx

RFP S-44000-00009689 – Market Stabilization Actuarial Services Att E

ATTACHMENT E

PRICE PROPOSAL SUBMISSION FORM

Company Name:

Contact Person:

Title:

Address:

Telephone:

Email:

Each Proposer must submit this Proposal Submission Form. The Proposal Submission Form must be signed and submitted in OregonBuys prior to the Bid Opening date December 31, 2024 at 2:00 PM PT.

By answering the following questions, Proposer denotes whether they meet or exceed all the following minimum qualifications of RFP Section 3.1. Agency reserves the right to determine if Proposer meets the minimum qualifications as part of the evaluation process.

Yes / No

1. Does Proposer have five years’ experience in the last seven years providing health insurance actuarial analyses and reports for consideration by audiences including insures, elected officials, public administrators and various stakeholders?

2. Does Proposer have experience in at least two states conduction actuarial analyses used for aspects of Affordable Care Act implementation?

3. Does Proposer’s assigned actuaries have five years’ experience in the last seven years of providing health insurance actuarial analyses and reports for consideration by audiences including insures, elected officials, public administrators and various stakeholders?

4. Are Proposer’s Key Persons a fellow or associate of the Society of Actuaries?

5. Are Proposer’s Key Persons a member in good standing of one or both of the following?

· The Society of Actuaries

· The American Academy of Actuaries

Agency is electing not to have Price Proposals entered in OregonBuys on the items tab.

When completing the quote process in OregonBuys, enter a cost of $1.00 only.

Price Proposal should be inclusive of all positions and related costs necessary to perform the requested Services, excluding any travel related expenses. Agency does not anticipate any travel expenses associated with these Services. Agency shall not reimburse any expenses, unless included in the Sample Contract, Statement of Work, or has been negotiated for a specific Work Order Contract. Comment by Franie Wilkins: In the SOW, we say the following:

“Examination will be principally conducted at the domestic insurance company’s home offices and may include other locations requested by Agency. “ Does this indicate travel? Comment by Kirsten Anderson: Our staff may travel. I don’t anticipate that they will. It’s possible if we run into something, especially since are having them do IT. Sometimes in the IT portion of the exam, they end up having to go onsite to look at the security, but we’ve done most of our exams remotely lately. In the last 10 or so, I think we’ve only had to go onsite once. So I think does not anticipate is a fair statement.

Add additional lines if needed for positions.

Rate Estimated Hours for Services

Position 1:

Position 2:

Position 3:

Position 4:

Position 5:

Position 6:

Position 7:

Position 8:

Price Proposal shall be firm for a period of 180 days from the Bid Opening of the RFP.

The SPC will conduct the price evaluation. The SPC will average the hourly rates proposed and then award a price score to each Price Proposal based upon the percentage of the proposed price as compared to the lowest Proposer’s price using the following formula:

price being scored

Note: Only positions and hourly rates included on this Proposal Submission Form will be included on the awarded Contract. If requested by Agency, any or travel costs will be negotiated separately.

SIGNATURE OF PROPOSER’S DULY AUTHORIZED REPRESENTATIVE

I, the undersigned, agree to be bound by the form of Agreement and all remaining contract documents, including instructions to Proposer’s; Standard Terms and Conditions; Special Conditions; Federal Provisions, if applicable; and Specifications.

I, the undersigned, certify compliance with State of Oregon statutory requirements governing registration of corporations and assumed business names.

I, the undersigned, certify that this Quote has been arrived at independently and has been submitted without any collusion designed to limit independent bidding or competition. I, the undersigned duly authorized representative of the Proposer, understand that the quote must be signed in ink by the Proposer and that any alterations or erasures must be initialed in ink by the person signing the quote. Further, I acknowledge that I have read and understand all quote instructions, specifications, terms and conditions, (including the attachments indicated above) and agree on behalf of myself and the Proposer to be bound by them.

I, the undersigned, duly authorized representative of the Proposer, certify that the information provided in this quote is true and accurate. Further, I understand and acknowledge that providing incorrect information may cause quote rejections or contract termination.

Company Name: __________________________________________________________________________________

Name of Authorized Representative: ___________________________________________________________

Title: _______________________________________________________________________________________________

Signature: _____________________________________________ Date: ____________________________________