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HomeMy WebLinkAboutCORRESPONDENCE - RFP - P682 (2)Administrative Services Purchasing Division -itv of Fort Collins January 2, 2002 Walter Coolidge, President American Stop Loss 200 Commercial St. STE 200 Worcester, MA 01608 Re: Renewal, #P-682 — Benefits (Stop Loss Claims) Dear Mr. Coolidge: The City of Fort Collins wishes to extend the agreement term for the above captioned proposal per the existing terms and conditions, with the following changes: contract basis changed to 24/12 at the $16.79 rate quoted. The term will be extended for one (1) additional year, January 1, 2002 through December31, 2002. If the renewal is acceptable to your firm, please sign this letter in the space provided and return it to the City of Fort Collins, Purchasing Division, P. O. Box 580, Fort Collins, CO 85022, within the next fifteen days. If this extension is not agreeable with your firm, we ask that you send us a written notice stating that you do not wish to renew the contract and state the reason for non -renewal. If you have any questions regarding this matter, please contact Keith Ashbv. CPPn R� �o�.,. 416-2247. Sincerely, m B. O'Neill Il, CPPO, FNIGP Di ctor of Purchasing and Risk Management cc: Vincent Pascale, Human Resources Pil Goldstein, William M. Mercer, Inc Proposal #P-682 Signature Date (Please indicate your desire to renew Proposal #P-682 by signing this letter and returning it to Purchasing Division within the next fifteen days.) 215 North Mason Street • 2nd Floor • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6775 • FAX (970) 221-6707 Keith: Please have Jim complete and sign the attached application for Stop Loss Coverage. It should be returned to Karen Rosati American Stop Loss 250 Commercial Street Suite 200 Worcester, MA 01608 Thanks, It " Vincent The Union Labor Lice Insurance company ig ��J uCaae.° 461 Park Avenus South Naw *k, New Yolk 1o01G 212.64b.6188 H77.797.771P 212.a83.34G8 fax www.ugicare.com Grouo Insurance and Health Services Request It is understood and agreed that: This request is based on the proposal dated December 2001and any additional quotations provided after that date. « This request must be received and approved by The Union Labor Life Insurance Company at Its Home Office in Washington, D.C. before the program can become effective on JANUARY 1, 2002. a The Union Labor Life Insurance Company reserves the right to contract any prior carrier for the purposes of obtaining factual date required for its underwriting review of this request for coverage, and the carrier is authorized to release such data. a No agent or broker is authorized to make, modify or waive any of The Union Labor Life insurance Company's rights or requirements. li All printed booklets, contrac,-m or certificates must receive the express written approval of The Union Labor Life Insurance Company. °i The following agent/broker of record will receive comm lesions upon receipt of an a uthorization letter from the Trustees:American Stop Loss. 61 Premiums will be paid in advance on a monthlybasis. A check for $ 23,000* accompanies this request and will be applied toward the first premium payment. Group Applicant: CITY OF FORT COLLINS Address: TA): ID .No: Signature —N a Name MeS B, Q°Ne 11 IT, CPPQ,FNIGP Director of Purchsstrig-& 1 itle Ms L Mgnagement Title j ZI 1-i O ( bate Date t0r