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HomeMy WebLinkAboutRFP - 8814 THIRD PARTY CLAIMS ADMINISTRATOR SERVICES (3)RFP 8814 Third Party Claims Administrator Page 1 of 26 REQUEST FOR PROPOSAL 8814 THIRD PARTY CLAIMS ADMINISTRATOR SERVICES The City of Fort Collins is requesting proposals from qualified Vendors for a Third Party Claims Administrator to provide self-insured workers' compensation and liability claims services. As part of the City’s commitment to Sustainable Purchasing, proposals submission via email is preferred. Proposals shall be submitted in a single Microsoft Word or PDF file under 20MB and e-mailed to: purchasing@fcgov.com. If electing to submit a hard copy proposal we require one (1) hard copy and one (1) electronic copy on a jump drive to be received at the City of Fort Collins' Purchasing Division, 215 North Mason St., 2nd floor, Fort Collins, Colorado 80524. Proposals must be received before 3:00 p.m. (our clock) on October 19, 2018 and referenced as Proposal No. 8814. If delivered, they are to be sent to 215 North Mason Street, 2nd Floor, Fort Collins, Colorado 80524. If mailed, the address is P.O. Box 580, Fort Collins, 80522-0580. Please note, additional time is required for bids mailed to the PO Box to be received at the Purchasing Office. The City encourages all Disadvantaged Business Enterprises (DBEs) to submit proposals in response to all requests for proposals. No individual or business will be discriminated against on the grounds of race, color, sex, or national origin. It is the City’s policy to create a level playing field on which DBEs can compete fairly and to ensure nondiscrimination in the award and administration of all contracts. All questions should be submitted, in writing via email, to Beth Diven, Buyer at bdiven@fcgov.com, with a copy to Project Manager, Sharon Klotz at sklotz@fcgov.com, no later than 5:00 PM MST (our clock) on October 10, 2018. Please format your e-mail to include: RFP [RFP # & Title] in the subject line. Questions received after this deadline may not be answered. Responses to all questions submitted before the deadline will be addressed in an addendum and posted on the Rocky Mountain E-Purchasing System webpage. Rocky Mountain E-Purchasing System hosted by Bidnet A copy of the RFP may be obtained at http://www.bidnetdirect.com/colorado/city-of-fort-collins. This RFP has been posted utilizing the following Commodity Code(s): 918-69 Insurance Consulting Services 958-61 Insurance and Risk Management Services Public Viewing Copy: The City is a governmental entity subject to the Colorado Open Records Act, C.R.S. §§ 24-72-200.1 et seq. (“CORA”). Any proposals submitted hereunder are subject to public disclosure by the City pursuant to CORA and City ordinances. Firms may submit one (1) additional complete proposal clearly marked “FOR PUBLIC VIEWING.” In this version of the proposal, the firm may redact text and/or data that it deems confidential or proprietary pursuant to CORA and such version must be clearly identified as “Confidential” or “Proprietary", as applicable. Such statement does not necessarily exempt such documentation from public disclosure if required by CORA, by order of a court of appropriate jurisdiction, or other applicable law. Generally, under CORA trade secrets, confidential commercial and financial Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707 fcgov.com/purchasing RFP 8814 Third Party Claims Administrator Page 2 of 26 data information is not required to be disclosed by the City. Proposals may not be marked “Confidential” or ‘Proprietary’ in their entirety. All provisions of any contract resulting from this request for proposal will be public information. New Vendors: The City requires new Vendors receiving awards from the City to fill out and submit an IRS form W-9 and to register for Direct Deposit (Electronic) payment. If needed, the W-9 form and the Vendor Direct Deposit Authorization Form can be found on the City’s Purchasing website at www.fcgov.com/purchasing under Vendor Reference Documents. Please do not submit with your proposal. Sales Prohibited/Conflict of Interest: No officer, employee, or member of City Council, shall have a financial interest in the sale to the City of any real or personal property, equipment, material, supplies or services where such officer or employee exercises directly or indirectly any decision-making authority concerning such sale or any supervisory authority over the services to be rendered. This rule also applies to subcontracts with the City. Soliciting or accepting any gift, gratuity favor, entertainment, kickback or any items of monetary value from any person who has or is seeking to do business with the City of Fort Collins is prohibited. Collusive or Sham Proposals: Any proposal deemed to be collusive or a sham proposal will be rejected and reported to authorities as such. Your authorized signature of this proposal assures that such proposal is genuine and is not a collusive or sham proposal. The City of Fort Collins reserves the right to reject any and all proposals and to waive any irregularities or informalities. Utilization of Award by Other Agencies: The City of Fort Collins reserves the right to allow other state and local governmental agencies, political subdivisions, and/or school districts to utilize the resulting award under all terms and conditions specified and upon agreement by all parties. Usage by any other entity shall not have a negative impact on the City of Fort Collins in the current term or in any future terms. The selected Vendor shall be expected to sign the City’s standard Agreement prior to commencing Services (see sample attached to this Proposal). Sincerely, Gerry Paul Purchasing Director RFP 8814 Third Party Claims Administrator Page 3 of 26 I. BACKGROUND & OBJECTIVE / OVERVIEW A. Objective The City of Fort Collins is requesting proposals from qualified Vendors for a Third Party Claims Administrator to provide self-insured workers' compensation, property and liability claims services. B. Background The City's purpose of this RFP is to select a qualified Third Party Claims Administrator to handle workers' compensation, property and liability claims. Evaluations of proposals in response to this RFP will be completed by City personnel with potential input from an independent third-party consultant. When evaluations of the written proposals are complete, top scoring vendors may be called upon to present their services to the evaluation team for further consideration. Upon completion of scoring and evaluation, a Services Agreement will be awarded. The Claims Administrator may administer workers' compensation, property and liability, or depending on excess markets, may administer a combination of coverage lines. Due to the need to maintain a close working relationship, and timely responses in the event of an incident requiring immediate assistance, the Claim Administrator may be required to have a servicing office in Fort Collins and/or committed capability for rapid response II. SCOPE OF PROPOSAL Proposals are to be submitted in strict compliance with these specifications. Any limitations or deviations from these specifications must be designated in the proposal; otherwise, companies proposing will be strictly held to the specifications. Failure to deliver services and fees quoted in your proposal may result in a mid-term cancellation of the Service Contract and a replacement of the Third Party Administration firm. The information contained in the specifications is believed to be correct but is not warranted. The responsibility for determining the full extent of the exposure and the verification of all information shall rest solely upon the Third Party Administrator. The City of Fort Collins or its representatives, will not be responsible for any errors or omissions, nor for the failure on the part of the Third Party Administrator to determine the full extent of the exposures. All Proposals must fully describe the nature of any ancillary services which your firm may offer. If independent firms are to be used, the name and address of the firms are to be shown. A. Scope of Work 1. Claims Management Standards and Procedures Following are standards and services the City wishes to maintain. Review these points and indicate any area that could be a problem in your firm. a) Claims Administration • Create files and reserve within two (2) working days from receipt of the initial report. RFP 8814 Third Party Claims Administrator Page 4 of 26 • Establish diaries so each claim is reviewed at least every thirty (30) days or more frequently where needed. Document confirmation of review. • Working with City of Fort Collins Risk Management staff, regularly examine and analyze all claims to determine compensability/validity of workers’ compensation and liability claims. • Pay bills promptly per City instructions. • Audit medical bills and repair bills for causal relationship and reasonableness of charges. • Report all indemnity claims to the Index Bureau upon file creation and retain a copy with the file. • Review medical-only claims for possible closure no less frequently than every thirty (30) days. • Provide copies of all written correspondence from the administrator to doctors, claimants, attorneys, rehabilitation counselors, investigators and state agencies. • Clearly document all file activity, including telephone conversations or personal meetings, and diary reviews to reflect the date, individuals involved, content of discussion and plan of action electronically and provide authorized City employee access. • Establish specific direction on the investigation and handling of all indemnity cases within three (3) working days from receipt of the initial report, and clearly evidenced in the file. • Notify appropriate excess insurer(s) of all claims or losses meeting the reporting requirements of the insurer and provide such insurer with all required information and updates. Send update reports to excess carriers no less frequently than semi-annually or as directed by the City. • Provide a written analysis or report of all proposed settlements by stipulation or compromise for consideration and authorization, in losses valued in excess of $50,000. • Establish claim reserves and provide a continual review and update of reserves to reflect changes. It is expected that reserves will be reviewed at least quarterly with staff. • Maintain a file for each claim submitted with the file available for review by the City at any reasonable time. • Consult and cooperate with employees as may be necessary to achieve a successful claims management program. This includes regular communications between City staff and the Third Party Administrator to discuss claim progress settlements and denials. • Consult quarterly with City Risk Management and Legal staff to review open claims and reserve settings. RFP 8814 Third Party Claims Administrator Page 5 of 26 b) Claims Investigation and Management • Conduct the necessary investigation of each claim using competent and qualified personnel, including such investigation as is necessary to determine liability. The City reserves the right to require additional investigation. With the approval of the City, engage the services of persons of firms outside its organization for special work in connection with investigations. • Contact or attempt to contact all employees and claimants within three (3) days of receipt of claim. Upon initial contact, document the description of injury/accident. Document attempts to contact employee or claimant. • Contact the department and designated employee for City's statement before determining liability. • Contact the City within three (3) days to confirm whether compensability/liability is acknowledged or should have been questioned. • Monitor treatment program for injured employees to assure that treatment is related to the compensable injury or illness. • Consult with City Risk Management staff prior to authorizing medical procedures. • Maintain a close liaison with treating physicians to assure that employees receive proper care and to avoid over treatment situations. • Determine eligibility for and authorize payment of Temporary Disability compensation in accordance with medical advice, rehabilitation efforts and State law. • With City approval, maintain telephone or personal contact with temporarily disabled employees no less frequently than monthly, to maintain rapport and to monitor medical progress and return to work status. • Schedule independent medical examinations with qualified physicians in cases where treatment, length of disability or extent of permanent disability assigned is in question. • Investigate whether subrogation can be ruled out or pursued in all cases which may involve third party negligence. • Refer litigated cases to attorneys utilizing an agreed listing of legal firms. Assist in the preparation of litigated cases and participate as needed in hearings and settlement actions. • Attend monthly meetings with City designated physician. c) Claim Analysis and Report • Provide the City with continuing information on the progress of individual claims and the effectiveness of cost control programs relating to all claims. A closing report is required for every claim indicating the amount paid to settle the claim. • Submit statistical summaries and narrative reports as requested to assist in the evaluation of the City programs. RFP 8814 Third Party Claims Administrator Page 6 of 26 • Assist the City in the analysis of claims in an effort to prevent future occurrences of a similar nature. • Maintain a claim file for each reported claim which shall be available to the City at all times for inspection. Such file shall contain all data pertinent to the claim to support its disposition and shall remain the exclusive property of the City. • Assist the City in preparation of required self-insurance reports, reports required by the City’s insurance carriers, and information for the National Council on Compensation Insurance (NCCI) to calculate the workers’ compensation modifier. d) Special Services • Provide information and guidance to City employees regarding workers' compensation benefits and respond to inquiries regarding specific injuries and permanent disability ratings. • When appropriate, develop rehabilitation programs for injured employees for approval by the City, the employee and appropriate agencies ensuring that rehabilitation, retraining or reassignment is provided to employees with physical or performance limitations resulting from industrial injuries. • Review existing City claims management programs and procedures and recommend changes as needed. 2. Claims Philosophy The City of Fort Collins' claims management philosophy is as follows: • Claimants are given a high standard of care and concern. • Employees are clearly advised of their benefits under Workers' Compensation in a timely fashion. • To give prompt attention to all claims matters and to discourage unnecessary litigation. • To encourage early recovery from injury and early return to productive work. • To encourage employees' return to work for modified duty. • To identify fraudulent claims and aggressively defend those claims. • To identify cause of loss and correct, if necessary, to prevent future loss. • To keep communication open between the Claim Administrator, Risk Management staff, employees, claimants, and medical providers. 3. Special Provisions a) Claim Assignment The City of Fort Collins does not send all claims to a Third Party Claims Administrator. The City Attorney’s Office and the Risk Management division reserve the right to determine which claims will be handled in-house and those that will be assigned to the third party administrator. RFP 8814 Third Party Claims Administrator Page 7 of 26 b) Cancelation by Administrator Firms must acknowledge in their proposal a written commitment to honor the rates and terms of the contract for the initial one (1) year term. c) Claims Run-off Provisions Ensure that your company's claims run-off requirements, including fees for present as well as future claims, are included with a proposed contract provision. d) Title Rights Ensure that the City shall have full, complete and absolute title to all studies, files, documents, correspondence, tapes, movies, recordings, reports, analyses and other materials prepared or acquired regardless of the state of completion. Further ensure that the City may make full and complete use of said materials as it desires, and within its own discretion without liability of any kind whatsoever to the Administrator other than payment of consideration as provided. B. Anticipated Schedule The following represents the City’s target schedule for the RFP. The City reserves the right to amend the target schedule at any time. • RFP issuance: September 28, 2018 • Question deadline: 5:00 PM MST on October 10, 2018 • Proposal due date: 3:00 MST (our clock) on October 19, 2018 • Interviews (tentative): Week of November 12, 2018 • Award of Contract (tentative): End of November 2018 • Service Start Date January 1, 2019 C. Interviews In addition to submitting a written proposal, the top-rated Vendors may be interviewed by the RFP assessment team and asked to participate in an oral presentation to provide an overview of the company, approach to the project and to address questions. The evaluation criteria for the oral interviews will be the same as the criteria for the written evaluations and is included in Section IV. D. Subcontractors Vendors will be responsible for identifying any subcontractors in their proposal. Please note that the City will contract solely with the awarded Vendor; therefore subcontractors will be the responsibility of the Vendor. E. Proposal Format Please limit the total length of your proposal to a maximum of twenty-five (25) double sided or fifty (50) single sided 8 ½ x 11” pages (excluding cover pages, table of contents, dividers and Vendor Statement form). Font shall be a minimum of 10 Arial and margins are limited to no less than .5” for sides and top/bottom. Extended page sizes, such as 11” RFP 8814 Third Party Claims Administrator Page 8 of 26 x 17”, count as a single page. Please, no embedded documents. Proposals that do not conform to these requirements may be rejected. F. Fees, Licenses, Permits The successful Vendor shall be responsible for obtaining any necessary licenses, fees or permits without additional expense to the City. All equipment shall be properly licensed and insured, carry the appropriate permits and be placarded as required by law. G. Laws and Regulations The Vendor agrees to comply fully with all applicable local, State of Colorado and Federal laws and regulations and municipal ordinances. H. Invoicing and Payment Invoices should be emailed monthly to invoices@fcgov.com with a copy to the Project Manager. The cost of the work completed shall be paid to the Vendor each month following the submittal of a correct invoice by the Vendor indicating the Purchase Order number, project name, task description, hours worked, personnel/work type category, hourly rate for each employee/work type category, date of the work performed specific to the task, percentage of that work that has been completed by task, 3rd party supporting documentation with the same detail and a brief progress report. Payments will be made using the prices listed on the agreed-to Price Schedule. In the event a service is requested which is not listed on the Price Schedule, the Vendor and the City will negotiate an appropriate unit price for the service prior to Consultant initiating such work. The City pays invoices on Net 30 terms. RFP 8814 Third Party Claims Administrator Page 9 of 26 III. CLAIMS DATA A. Five Year Claim History Workers’ Compensation Year # Claims # Med Only # Indemnity # Open Incurred Cost 2013 321 130 37 0 $799,614.57 2014 284 114 38 0 $817,648.13 2015 314 120 48 4 $1,479,541.33 2016 270 104 32 2 $508,365.53 2017 228 104 53 11 $787,278.30 2018* 186 71 26 28 $210,961.92 Auto Liability Year # Claims # Open Incurred Cost 2013 52 0 $86,101.68 2014 72 0 $82,329.75 2015 55 0 $84,258.28 2016 69 0 $110,290.86 2017 37 5 $133,535.07 2018* 25 4 $108,491.96 General Liability Year # Claims # Open Incurred Cost 2013 104 0 $913,781.24 2014 101 1 $263,484.98 2015 121 3 $519,158.49 2016 145 7 $742,675.79 2017 138 14 $319,336.36 2018* 77 32 $266,652.13 Of the auto liability and general liability claims listed, the City of Fort Collins handles approximately 100 of these claims in-house per year. The Claims Administrator will be responsible for either issuing a check for payment or a denial letter on these files. * Year to date information as of September 25, 2018. RFP 8814 Third Party Claims Administrator Page 10 of 26 IV. PROPOSAL SUBMITTAL For this section, Vendors are required to provide detailed written responses to the following items in the order outlined below. The responses shall be considered technical offers of what Vendors propose to provide and shall be incorporated in the contract award as deemed appropriate by the City. A proposal that does not include all the information required may be deemed non-responsive and subject to rejection. Responses must include all the items in the order listed below. It is suggested that the Vendors include each of the City’s questions with their response immediately following the question. The City of Fort Collins shall not reimburse any firm for costs incurred in the preparation and presentation of their proposal. A. Cover Letter / Executive Summary The Executive Summary should highlight the content of the proposal and features of the program offered, including a general description of the program and any unique aspects or benefits provided by your firm. Indicate your availability to participate in the interviews/demonstrations on the proposed dates as stated in the Schedule section. B. Qualification 1. Give a brief description of your firm including: • Names of principal owners, partners or officers. • Length of time the firm has been in business. • Number of offices and locations. • Offices that would service this account. • The availability of a toll-free number and/or e-mail address for the use of claimants, and the City. 2. Indicate the proposed number of personnel (including supervisory and management) who would be assigned to administer the City's program and give details regarding: • Position of each • Experience and education • Experience with public entities • Length of time with your firm • Computer skills 3. Would technical personnel be assigned to the City? If so, how many? 4. Would an Account Executive be assigned as the primary contact on items not directly related to specific claims? 5. Describe training programs offered to claim personnel and incentives for employees to further their training and education. 6. In the past two years, what percentage of employee turnover has your firm experienced for the office that will be handling the City’s claims? RFP 8814 Third Party Claims Administrator Page 11 of 26 7. What is the anticipated case load of open files that would be managed by examiners assigned to this account? 8. Provide names, addresses, telephone numbers and length of service with at least three Colorado references for which you have provided worker's compensation, property and liability claims services (preferably public agencies). 9. Describe any additional special programs or areas of emphasis that you think would be beneficial in helping us to understand your level of expertise. C. Claims Implementation, Processing and Termination 1. Provide procedure and timetable for initial set-up and implementation of City's account into your system. 2. Provide the set-up, process and timetable for a new claim to be placed in the system. 3. Advise how frequently your diary system allows claims supervisory personnel to review open claims. 4. Describe your procedures for making initial and follow-up contact with injured employees or claimants. 5. Describe your company philosophy and procedures for the establishment of case reserves. What are the procedures for revising reserves? 6. Describe cost containment procedures utilized by your firm. 7. Describe how medical bill review services take place within your firm or contractor and provide a cost benefit analysis of its potential effect on the City. 8. Under the current arrangement, the City provides an account and checks for the processing of claim payments by the claim administrator. Indicate if this system would work for your firm. 9. Advise in what instances an independent adjustor would be required and which independent claims service you would use. 10. Attach copies of all standard forms used in your administration process. 11. Submit samples of any cards, letters, pamphlets, etc. that would be provided to injured employees and claimants. 12. Do you have a formal program for managing lawsuits and litigation expense? If so, please describe. 13. Provide the City with various options regarding the handling of open claims in the event of termination or regular expiration of the Services Agreement. 14. Include any other information that you feel would contribute a positive and successful program if your firm were selected. Describe in detail the Claims Administrator's various investigative techniques and general claim handling philosophies, addressing the following: • Method of explaining claimant's right. • Circumstances when in-person investigations would be used rather than by telephone. • Philosophy and method of contesting and denying claims payments. RFP 8814 Third Party Claims Administrator Page 12 of 26 15. Provide a description of the quality controls currently in place. The description should include the approach to and frequency of internal claims audits of claims offices. D. Data Processing and Reporting Services 1. Provide a sample report and/or details for reporting capability. 2. Indicate whether the following reports could be provided online: • Incident analysis report giving a breakdown by cause, body part, injury, day, time, etc. • Vendor report to identify service providers and attorney involvement. • Cumulative check register giving a summary of all medical, indemnity and other payments to date. • Reports showing IBNR factors and trending, claims pay-out profiles and claims development analysis. • Sorting capabilities of program. • OSHA 300 Log • Recordable Accident Frequency Rate (RAF) • Days Away, Restricted or Transferred (DART) 3. Can your organization customize reports for our needs? Is there an extra charge for this service? 4. Can reports be exported to an MS Excel, Access or PDF format? 5. Can your organization interface with the J. D. Edwards One World Workforce Management System? 6. Does your organization have the capability to captures all correspondence, medical records, letters, etc., electronically and store them in the claimants file? 7. Is it possible for authorized City personnel to access your data base? If so, please describe your system, the necessary mechanics, and what information would be available to access. 8. Advise how frequently your system is updated. 9. Please submit samples of each standard report generated by your system and explain any additional ad hoc reporting capability you could put at our disposal. 10. Describe how your firm ensures the confidentiality of client data. E. Availability 1. Approximately how far is the servicing office from downtown Fort Collins? Is an operational office in Fort Collins at contract inception an option for one, or all lines of claims? 2. Can your firm respond immediately to investigate an incident that has just occurred? Indicate how long it would take a claim representative to physically be on-site of an incident after telephone notification. RFP 8814 Third Party Claims Administrator Page 13 of 26 3. Are your claim representatives "on call" 24 hours per day? Are pagers, cell phones or similar devices provided to the representatives? 4. How many representatives could reasonably be expected to handle claims for the City? 5. What is the claims ratio between an adjuster and the number of claims handled? F. Pricing and Fees If different pricing and fees are used for workers' compensation and liability, please quote separately. 1. Quote the per claim fee in one or more of these ways: • Cost per claim (regardless of type). • Cost per claim by type. • Minimum cost/maximum costs. • Lifetime handling of claims. 2. Annual Flat Fee • If a flat fee is submitted, it must be for a for a specified number of claims per year for lifetime management of those claims. The annual flat fee may not set numeric limitations of claim type within the total annual allotment. • Also indicate the additional fee per claim to be paid if the number of claims handled by the T.P.A. exceeds the number of claims specified in the annual allotment. 3. Specify whether your fee includes all the necessary state filing. 4. Indicate whether the per claim cost includes recovery of subrogation losses. 5. Indicate the types of allocated claims expenses which are not included in your per case claims costs. 6. State what services or type of claims that are not included in your standard fees. 7. What Northern Colorado health care providers are part of your PPO network and what discount do you receive? 8. Explain your prescription drug program and bill review processes. 9. Since the term of the contract will be five years, renewable annually, give an indication of expected rate changes, basis for changes, and how your firm intends to control cost. G. Sustainability/TBL Methodology In concise terms (no more than two pages), please describe how your organization strives to be sustainable. Address how your firm incorporates Triple Bottom Line (TBL) into the workplace. See Section IV: Review and Assessment for additional information. If possible, please highlight areas of opportunity in the project where sustainability could be applied and/or improved. H. Additional Information Provide any information that distinguishes Vendor from its competition and any additional information applicable to this RFP that might be valuable in assessing Vendor’s proposal. RFP 8814 Third Party Claims Administrator Page 14 of 26 Explain any concerns Vendor may have in maintaining objectivity in recommending the best solution. All potential conflicts of interest must be disclosed. Exceptions to the Scope of Services and City Agreement (a sample of which is attached in Section VI) shall be documented. V. REVIEW AND ASSESSMENT CRITERIA A. Proposal and Interview Criteria Vendors will be evaluated on the following criteria. These criteria will be the basis for review and assessment of the written proposals and optional interview session. At the discretion of the City, interviews of the top-rated Vendors may be conducted. The rating scale shall be from 1 to 5, with 1 being a poor rating, 3 being an average rating, and 5 being an outstanding rating. WEIGHTING FACTOR QUALIFICATION STANDARD 2.0 Scope of Proposal Does the proposal address all elements of the RFP? Does the proposal show an understanding of the project objectives, methodology to be used and results/outcomes required by the project? Are there any exceptions to the specifications, Scope of Work, or agreement? 2.0 Firm Capability Does the firm have the resources, financial strength, capacity and support capabilities required to successfully complete the project on-time and in-budget? Has the firm successfully completed previous projects of this type and scope? 2.0 Assigned Personnel Do the persons who will be working on the project have the necessary skills and qualifications? Are sufficient people of the requisite skills and qualifications assigned to the project? 1.0 Availability Can the work be completed in the necessary time? Can the target start and completion dates be met? Are other qualified personnel available to assist in meeting the project schedule if required? Is the project team available to attend meetings as required by the Scope of Work? 1.0 Computer Support and Reports Are reporting capabilities accessible online? Can reports be customized and downloaded in multiple formats? How is confidential client data secured? 2.0 Cost & Work Hours Does the proposal included detailed cost break-down for each cost element as applicable and are the line-item costs competitive? Do the proposed cost and work hours compare favorably with the Project Manager's estimate? Are the work hours presented reasonable for the effort required by each project task or phase? RFP 8814 Third Party Claims Administrator Page 15 of 26 B. Reference Evaluation Criteria Prior to award, the Project Manager will check references using the following criteria. Negative responses from references may impact the award determination. CRITERIA STANDARD QUESTIONS Overall Performance Would you hire this Vendor again? Did they show the skills required by this project? Timetable Was the original Scope of Work completed within the specified time? Were interim deadlines met in a timely manner? Completeness Was the Vendor responsive to client needs; did the Vendor anticipate problems? Were problems solved quickly and effectively? Budget Was the original Scope of Work completed within the project budget? Job Knowledge If a study, did it meet the Scope of Work? If Vendor administered a construction contract, was the project functional upon completion and did it operate properly? Were problems corrected quickly and effectively? RFP 8814 Third Party Claims Administrator Page 16 of 26 VI. VENDOR STATEMENT Vendor hereby acknowledges receipt of the City of Fort Collins Request for Proposal and acknowledges that it has read and agrees to be fully bound by all of the terms, conditions and other provisions set forth in the RFP. Additionally, Vendor hereby makes the following representations to City: a. All of the statements and representations made in this proposal are true to the best of the Vendor’s knowledge and belief. b. Vendor commits that it is able to meet the terms provided in this proposal. c. This proposal is a firm and binding offer, for a period of 90 days from the date hereof. d. Vendor further agrees that the method of award is acceptable. e. Vendor also agrees to complete the proposed Agreement with the City of Fort Collins within 30 days of notice of award. If contract is not completed and signed within 30 days, City reserves the right to cancel and award to the next highest rated firm. f. Vendor acknowledge receipt of addenda. Firm Name: Physical Address: Remit to Address: Phone: Name of Authorized Agent of Firm: Signature of Authorized Agent: Primary Contact for Project: Title: Email Address: Phone: Cell Phone: NOTE: VENDOR STATEMENT IS TO BE SIGNED & RETURNED WITH YOUR PROPOSAL. Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 17 of 26 VII. SAMPLE AGREEMENT (FOR REFERENCE ONLY – DO NOT SIGN ) SERVICES AGREEMENT THIS AGREEMENT made and entered into the day and year set forth below by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City" and , hereinafter referred to as "Service Provider". WITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: 1. Scope of Services. The Service Provider agrees to provide services in accordance with the scope of services attached hereto as Exhibit A, consisting of ( ) page(s) and incorporated herein by this reference. Irrespective of references in Exhibit A to certain named third parties, Service Provider shall be solely responsible for performance of all duties hereunder. 2. The Work Schedule. [Optional] The services to be performed pursuant to this Agreement shall be performed in accordance with the Work Schedule attached hereto as Exhibit , consisting of ( ) page(s), and incorporated herein by this reference. 3. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated within ( ) days following execution of this Agreement. Services shall be completed no later than . Time is of the essence. Any extensions of the time limit set forth above must be agreed upon in a writing signed by the parties. 4. Contract Period. This Agreement shall commence , 20 , and shall continue in full force and effect until , 20 , unless sooner terminated as herein provided. In addition, at the option of the City, the Agreement may be extended for additional one year periods not to exceed ( ) additional one year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties. Written notice of renewal shall be provided to the Service Provider and mailed no later than thirty (30) days prior to contract end. 5. Delay. If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without its fault or negligence, then the party so prevented shall be excused from whatever performance is prevented by such cause. To the extent that the performance is actually prevented, the Service Provider must provide written notice to the City of such condition within fifteen (15) days from the onset of such condition. 6. Early Termination by City/Notice. Notwithstanding the time periods contained herein, the City may terminate this Agreement at any time without cause by providing written notice of Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 18 of 26 termination to the Service Provider. Such notice shall be delivered at least fifteen (15) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses: Service Provider: City: Copy to: Attn: City of Fort Collins Attn: PO Box 580 Fort Collins, CO 80522 City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 In the event of early termination by the City, the Service Provider shall be paid for services rendered to the date of termination, subject only to the satisfactory performance of the Service Provider's obligations under this Agreement. Such payment shall be the Service Provider's sole right and remedy for such termination. 7. Contract Sum. The City shall pay the Service Provider for the performance of this Contract, subject to additions and deletions provided herein, ($ ) as per the attached Exhibit " ", consisting of page(s), and incorporated herein by this reference. 8. City Representative. The City will designate, prior to commencement of the work, its representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the services provided under this agreement. All requests concerning this agreement shall be directed to the City Representative. 9. Independent Service provider. The services to be performed by Service Provider are those of an independent service provider and not of an employee of the City of Fort Collins. The City shall not be responsible for withholding any portion of Service Provider's compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose. 10. Subcontractors. Service Provider may not subcontract any of the Work set forth in the Exhibit A, Statement of Work without the prior written consent of the city, which shall not be unreasonably withheld. If any of the Work is subcontracted hereunder (with the consent of the City), then the following provisions shall apply: (a) the subcontractor must be a reputable, qualified firm with an established record of successful performance in its respective trade performing identical or substantially similar work, (b) the subcontractor will be required to comply with all applicable terms of this Agreement, (c) the subcontract will not create any contractual relationship between any such subcontractor and the City, nor will it obligate the City to pay or see to the payment of any subcontractor, and (d) the work of the subcontractor will be subject to inspection by the City to the same extent as the work of the Service Provider. 11. Personal Services. It is understood that the City enters into the Agreement based on the special abilities of the Service Provider and that this Agreement shall be considered as an agreement for personal services. Accordingly, the Service Provider shall neither assign any Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 19 of 26 responsibilities nor delegate any duties arising under the Agreement without the prior written consent of the City. 12. Acceptance Not Waiver. The City's approval or acceptance of, or payment for any of the services shall not be construed to operate as a waiver of any rights or benefits provided to the City under this Agreement or cause of action arising out of performance of this Agreement. 13. Warranty. a. Service Provider warrants that all work performed hereunder shall be performed with the highest degree of competence and care in accordance with accepted standards for work of a similar nature. b. Unless otherwise provided in the Agreement, all materials and equipment incorporated into any work shall be new and, where not specified, of the most suitable grade of their respective kinds for their intended use, and all workmanship shall be acceptable to City. c. Service Provider warrants all equipment, materials, labor and other work, provided under this Agreement, except City-furnished materials, equipment and labor, against defects and nonconformances in design, materials and workmanship/workwomanship for a period beginning with the start of the work and ending twelve (12) months from and after final acceptance under the Agreement, regardless whether the same were furnished or performed by Service Provider or by any of its subcontractors of any tier. Upon receipt of written notice from City of any such defect or nonconformances, the affected item or part thereof shall be redesigned, repaired or replaced by Service Provider in a manner and at a time acceptable to City. 14. Default. Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either party should fail or refuse to perform according to the terms of this agreement, such party may be declared in default thereof. 15. Remedies. In the event a party has been declared in default, such defaulting party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail himself of any other remedy at law or equity. If the non-defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees and costs incurred because of the default. 16. Binding Effect. This writing, together with the exhibits hereto, constitutes the entire agreement between the parties and shall be binding upon said parties, their officers, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties. 17. Indemnity/Insurance. Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 20 of 26 a. The Service Provider agrees to indemnify and save harmless the City, its officers, agents and employees against and from any and all actions, suits, claims, demands or liability of any character whatsoever brought or asserted for injuries to or death of any person or persons, or damages to property arising out of, result from or occurring in connection with the performance of any service hereunder. b. The Service Provider shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property. c. Without limiting any of the Service Provider's obligations hereunder, the Service Provider shall provide and maintain insurance coverage naming the City as an additional insured under this Agreement of the type and with the limits specified within Exhibit , consisting of one (1) page, attached hereto and incorporated herein by this reference. The Service Provider before commencing services hereunder, shall deliver to the City's Purchasing Director, P. O. Box 580, Fort Collins, Colorado 80522, one copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the City. 18. Entire Agreement. This Agreement, along with all Exhibits and other documents incorporated herein, shall constitute the entire Agreement of the parties. Covenants or representations not contained in this Agreement shall not be binding on the parties. 19. Law/Severability. The laws of the State of Colorado shall govern the construction interpretation, execution and enforcement of this Agreement. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement. 20. Prohibition Against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et. seq., Service Provider represents and agrees that: a. As of the date of this Agreement: 1. Service Provider does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Service Provider will participate in either the e-Verify program created in Public Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108th Congress, as amended, administered by the United States Department of Homeland Security (the “e-Verify Program”) or the Department Program (the “Department Program”), an employment verification program established pursuant to Section 8- 17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired employees to perform work under this Agreement. b. Service Provider shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or knowingly enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien to perform work under this Agreement. Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 21 of 26 c. Service Provider is prohibited from using the e-Verify Program or Department Program procedures to undertake pre-employment screening of job applicants while this Agreement is being performed. d. If Service Provider obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Service Provider shall: 1. Notify such subcontractor and the City within three days that Service Provider has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and 2. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to this section the subcontractor does not cease employing or contracting with the illegal alien; except that Service Provider shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. e. Service Provider shall comply with any reasonable request by the Colorado Department of Labor and Employment (the “Department”) made in the course of an investigation that the Department undertakes or is undertaking pursuant to the authority established in Subsection 8-17.5-102 (5), C.R.S. f. If Service Provider violates any provision of this Agreement pertaining to the duties imposed by Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If this Agreement is so terminated, Service Provider shall be liable for actual and consequential damages to the City arising out of Service Provider’s violation of Subsection 8-17.5-102, C.R.S. g. The City will notify the Office of the Secretary of State if Service Provider violates this provision of this Agreement and the City terminates the Agreement for such breach. 21. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit - Confidentiality, consisting of one (1) page, attached hereto and incorporated herein by this reference. Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 22 of 26 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul Purchasing Director DATE: ATTEST: APPROVED AS TO FORM: SERVICE PROVIDER'S NAME By: Printed: Title: CORPORATE PRESIDENT OR VICE PRESIDENT Date: Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 23 of 26 EXHIBIT A SCOPE OF SERVICES Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 24 of 26 EXHIBIT (BID SCHEDULE/COMPENSATION) Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 25 of 26 EXHIBIT INSURANCE REQUIREMENTS 1. The Service Provider will provide, from insurance companies acceptable to the City, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Service Provider shall furnish the City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies, and containing substantially the following statement: “The insurance evidenced by this Certificate will not reduce coverage or limits and will not be cancelled, except after thirty (30) days written notice has been received by the City of Fort Collins.” In case of the breach of any provision of the Insurance Requirements, the City, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement. The City, its officers, agents and employees shall be named as additional insureds on the Service Provider 's general liability and automobile liability insurance policies for any claims arising out of work performed under this Agreement. 2. Insurance coverages shall be as follows: A. Workers' Compensation & Employer's Liability. The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement: 1. Workers' Compensation insurance with statutory limits as required by Colorado law. 2. Employer's Liability insurance with limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee. B. Commercial General & Vehicle Liability. The Service Provider shall maintain during the life of this Agreement such commercial general liability and automobile liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a "broad form" basis. The amount of insurance for each coverage, Commercial General and Vehicle, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. In the event any work is performed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance. Official Purchasing Document Last updated 10/2017 RFP 8814 Third Party Claims Administrator Page 26 of 26 EXHIBIT CONFIDENTIALITY IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) pursuant to this Agreement (the “Agreement”), the Service Provider hereby acknowledges that it has been informed that the City has established policies and procedures with regard to the handling of confidential information and other sensitive materials. In consideration of access to certain information, data and material (hereinafter individually and collectively, regardless of nature, referred to as “information”) that are the property of and/or relate to the City or its employees, customers or suppliers, which access is related to the performance of services that the Service Provider has agreed to perform, the Service Provider hereby acknowledges and agrees as follows: That information that has or will come into its possession or knowledge in connection with the performance of services for the City may be confidential and/or proprietary. The Service Provider agrees to treat as confidential (a) all information that is owned by the City, or that relates to the business of the City, or that is used by the City in carrying on business, and (b) all information that is proprietary to a third party (including but not limited to customers and suppliers of the City). The Service Provider shall not disclose any such information to any person not having a legitimate need-to-know for purposes authorized by the City. Further, the Service Provider shall not use such information to obtain any economic or other benefit for itself, or any third party, except as specifically authorized by the City. The foregoing to the contrary notwithstanding, the Service Provider understands that it shall have no obligation under this Agreement with respect to information and material that (a) becomes generally known to the public by publication or some means other than a breach of duty of this Agreement, or (b) is required by law, regulation or court order to be disclosed, provided that the request for such disclosure is proper and the disclosure does not exceed that which is required. In the event of any disclosure under (b) above, the Service Provider shall furnish a copy of this Agreement to anyone to whom it is required to make such disclosure and shall promptly advise the City in writing of each such disclosure. In the event that the Service Provider ceases to perform services for the City, or the City so requests for any reason, the Service Provider shall promptly return to the City any and all information described hereinabove, including all copies, notes and/or summaries (handwritten or mechanically produced) thereof, in its possession or control or as to which it otherwise has access. The Service Provider understands and agrees that the City’s remedies at law for a breach of the Service Provider’s obligations under this Confidentiality Agreement may be inadequate and that the City shall, in the event of any such breach, be entitled to seek equitable relief (including without limitation preliminary and permanent injunctive relief and specific performance) in addition to all other remedies provided hereunder or available at law.