1701 MOUNTAIN INDUSTRIAL BOULEVARD, STONE MOUNTAIN, GEORGIA 30083
http://www.dekalbschoolsga.org/solicitations
https://dekalbschoolsga.ionwave.net/Login.aspx
March 3, 2022
REQUEST FOR PROPOSALS (RFP) 22-490
INSURANCE PRODUCER SERVICES FOR
PROPERTY AND CASUALTY INSURANCE
PROPOSAL SUBMISSION DEADLINE - 2:00 PM, TUESDAY, MARCH 29, 2022
PUBLIC PROPOSAL ACKNOWLEDGEMENT - 3:00 PM, TUESDAY, MARCH 29, 2022
DeKalb County School District
Purchasing/Finance Department
1701 Mountain Industrial Boulevard
Stone Mountain, Georgia 30083
PROPOSALS RECEIVED AFTER THE DEADLINE SHALL BE CONSIDERED
NON-RESPONSIVE AND REJECTED.
PROPOSALS TO BE ACKNOWLEDGED PUBLICLY AT THE FOLLOWING TIME/LOCATION:
3:00 PM, Tuesday, March 29, 2022
DeKalb County School District
Finance Conference Room
1701 Mountain Industrial Blvd.
Stone Mountain, Georgia 30083
RFP Contact Person is: Carla L. Smith at 678.676.0120 or Phyllis Jones at 678.676.0285
or email purchasing at solicitationquestions@dekalbschoolsga.org
THE PERSON SIGNING THIS RFP MUST BE LEGALLY AUTHORIZED TO BIND THE COMPANY.
COMPANY NAME ____________________________________________________ _________________________________________________________
PRINT CERTIFYING/ENGAGING COMPANY OFFICIAL’S NAME
ADDRESS ___________________________________________________________ _________________________________________________________
SIGNATURE OF CERTIFYING/ENGAGING COMPANY OFFICIAL
___________________________________________________________________ _________________________________________________________
TITLE OF CERTIFYING/ENGAGING COMPANY OFFICIAL
___________________________________________________________________
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 2
AREA CODE, TELEPHONE NO., AND EXTENSION _____ _____ - ______ ______ _____ _____ _____ _____ _____
FEDERAL I.D. NUMBER
___________________________________________________________________ __________________________________________________
OFFEROR FAX NUMBER DATE
OFFEROR E-MAIL ADDRESS___________________________________________ OFFEROR WEB ADDRESS___________________________________
Time is of the essence. Specify your earliest __________ and latest __________ service commencement dates
after receipt of award letter.
Approval by the DeKalb County Board of Education
Official approval by the DeKalb County Board of Education is required for this procurement. No contract shall be
construed to be formed without the advance official approval of the DeKalb County Board of Education. The
successful offeror will be notified after DeKalb County Board of Education approval.
Funding Provisions
No award or contract will be made if funding is not approved by the DeKalb County Board of Education.
Compliance With Requirements
Offeror must indicate below whether or not their proposal is in complete compliance with the stated requirements.
If there are any deviations from these requirements, offeror must indicate in writing what the exact deviations
are and what actual services will be provided. Attach and label additional sheets if necessary.
___ Proposal is in complete compliance with proposal requirements.
___ Proposal deviates from stated requirements as follows:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Cancellation
Awards, contracts, and renewals may be canceled for convenience by the DeKalb County School District (DCSD)
at any time. In the event of termination of contract by DCSD, the DCSD will be responsible only for those services
that have been delivered and accepted according to the RFP requirements. Any cancellation for convenience
by DCSD shall be effective three (3) business days after receipt of the Notice of Cancellation for convenience
from DCSD by the Offeror.
Fiscal Year Funding Implications
The fiscal year for DCSD begins July 1 and ends June 30. This solicitation and any resulting contract(s) may
contain renewal options. This solicitation, any resulting contract(s), and any renewal options shall terminate
absolutely without further obligation on the part of DCSD at the end of the fiscal year in which this solicitation
was issued and at each June 30 renewal anniversary date thereafter unless the successful offeror is notified
otherwise and agrees in writing to the exercise of renewal options.
Payment to Successful Vendor(s)
Payment for goods and services will be made by electronic funds transfer (EFT) or ACH Paymode.
Vendor(s)/Supplier(s) doing business with DCSD are required to provide payment information when registering
as a DCSD vendor at: https://www.dekalbschoolsga.org/purchasing/. Offerors must sign below acknowledging
the above statement.
Signature of Engaging Official: ______________________________________________
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 3
Date: _________________ ______________________________________________
(Supplier Name / Certifying Official Signature)
Rights Reserved
DCSD reserves the right to accept or reject any and/or all parts of responsive proposals received and/or to reject
all proposals submitted. DCSD reserves the right to award any resulting contract in the manner that is in the
best interest of and most advantageous to DCSD. DCSD reserves the right to waive any technicalities or minor
irregularities in responses received and to award the contract in the most beneficial manner for DCSD. The
decision of DCSD shall be final. DCSD reserves the right to request and negotiate a “best and final” response
from offerors.
Taxes
Purchases made by DCSD are not subject to federal, state, or local sales tax. A Sales Tax Exemption Certificate
will be furnished upon request.
F.O.B. Delivery
All prices are to be F.O.B. delivery to various DCSD locations.
Estimated Quantities
The quantities shown in this RFP document are estimates, which are provided for your information. However,
actual quantities purchased by DCSD may vary.
Exclusions of Trade Usages
This RFP contains all of the terms, conditions and obligations to which the parties agree, and shall not be
modified, controlled, explained, supplemented or affected in any way by any usage of trade not expressly
included in this agreement.
No Obligation/No Award Guaranteed/Cost to Propose
The contract, if any, will be awarded to the offeror whose proposal offers the best value to DCSD in meeting the
required scope of work described herein, if the appropriate funds are available and the contract is approved by
the DeKalb County Board of Education. No obligation or commitment is incurred by the DeKalb County Board
of Education from the receipt of any proposal, marketing materials, or presentations. There is no guarantee that
any offeror will receive an award as a result of submitting a proposal. Any/all costs incurred by the offeror in
preparation and submission of this proposal are the sole responsibility of the offeror. Expenses incurred by the
offeror will not be reimbursed by DCSD or become a reason for contracting with the offeror. Offeror must sign
below acknowledging the above statement:
Signature of Engaging Official: ___________________________________________ Date: _____________
(Company Name / Certifying Official Signature)
Conditional Proposals
Proposals that are conditional and/or in any way qualify or vary from the terms of these instructions, conditions,
and specifications shall be considered non-responsive and disqualified.
Offeror Failure
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 4
In the event services to be furnished by the successful offeror should for any reason fail to conform to the scope
of work contained herein, DCSD reserves the right to reject the services and further reserves the right to
terminate the contract.
Failure of the successful offeror to perform contracted services may also result in the removal of that offeror from
doing business with DCSD for a period of not less than one year.
Georgia Open Records Act
All proposals submitted in response to DCSD solicitations may be subject to the Georgia Open Records Act,
which permits any member of the public to inspect and/or copy documents prepared and maintained or received
in the course of the operation of the public office or agency.
No Assignment of Award
The successful offeror may not assign the award or contract to or subcontract with another party without the
express written permission of DCSD.
The Laws of the State of Georgia
This RFP and subsequent agreement are subject to the laws of the State of Georgia.
Additional Terms
In the event an award is made to an offeror, the resulting contract shall not depart from this document unless
agreed to in writing by DCSD and the successful offeror. DCSD shall not be bound by additional terms and
conditions and/or extraneous language added to this document by offerors.
ALL SOLICITATIONS ISSUED BY DCSD ARE ADVERTISED IN THE LEGAL SECTION OF THE
CHAMPION NEWSPAPER, (404) 373-7779, POSTED ON THE IONWAVE DCSD WEBSITE,
DEMAND STAR AND POSTED IN THE TEAM GEORGIA MARKETPLACE’S GEORGIA
PROCUREMENT REGISTRY. Offerors are solely responsible for reviewing and making
themselves aware of DCSD solicitations posted on the following website:
https://dekalbschoolsga.ionwave.net/Login.aspx
Proposal responses will be received in the Purchasing Office between the hours of 8:30 AM and
4:30 PM only, Monday through Friday, excluding DCSD holidays, furlough days, and inclement
weather closings.
DCSD is not responsible for misdirected mail, mail not received, and/or mail delivered late by
designated carriers.
PROPOSALS RECEIVED IN THE PURCHASING OFFICE AFTER THE STATED DEADLINE DATE
AND TIME SHALL BE CONSIDERED NON-RESPONSIVE AND REJECTED.
PROPOSALS DELIVERED TO ANY SCHOOL OR LOCATION OTHER THAN THE DCSD
PURCHASING DEPARTMENT SHALL BE CONSIDERED NON-RESPONSIVE AND REJECTED.
PROPOSALS THAT ARE DELIVERED BY EXPRESS CARRIER (e.g., FEDEX, UPS) AND
RECEIVED IN THE DCSD MAILROOM WITH VERIFYING SIGNATURE BEFORE THE SCHEDULED
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 5
PROPOSAL DEADLINE SHALL BE CONSIDERED RESPONSIVE AND ENTERED INTO THE
PROPOSAL TABULATION.
LABELS WITH THE PROPER IDENTIFICATION INFORMATION ARE PROVIDED IN YOUR
REQUEST FOR PROPOSAL PACKAGE FOR YOUR CONVENIENCE AND USE. YOU MAY ALSO
DOWNLOAD LABELS FROM THE DCSD WEBSITE BY CHOOSING ATTACHMENT 1 AT:
https://dekalbschoolsga.ionwave.net/Login.aspx
SEALED PROPOSAL RESPONSES MUST BE CORRECTLY ADDRESSED AS SHOWN ON THE
REQUEST FOR PROPOSAL COVER SHEET.
BOXES OR EXPRESS CARRIER PACKAGES CONTAINING SEALED PROPOSALS MUST BE
CORRECTLY ADDRESSED AS WELL.
PROPOSALS RECEIVED BY TELEGRAM, FACSIMILE, E-MAIL, OR TELEPHONE WILL NOT BE
ACCEPTED.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 6
NOTICE TO OFFERORS
FOR SECURITY REASONS, ALL OFFERORS ATTENDING THE PUBLIC PROPOSAL
ACKNOWLEDGEMENT MUST REGISTER AT THE FIRST FLOOR FRONT DESK AT 1701
MOUNTAIN INDUSTRIAL BOULEVARD, STONE MOUNTAIN, GEORGIA 30083, BEFORE
ATTENDING THE PROPOSAL ACKNOWLEDGEMENT.
ALL OFFERORS SUBMITTING SEALED PROPOSALS IN PERSON TO THE PURCHASING
DEPARTMENT MUST HAVE THEIR SEALED PROPOSALS STAMPED WITH THE DATE AND
TIME BY A PURCHASING DEPARTMENT REPRESENTATIVE AND MUST LEAVE THEIR
SEALED PROPOSALS IN THE CARE OF A PURCHASING DEPARTMENT REPRESENTATIVE.
PURCHASING DEPARTMENT REPRESENTATIVES WILL ISSUE RECEIPTS FOR SEALED
PROPOSALS IF REQUESTED.
SEALED PROPOSALS LEFT RANDOMLY AT THE BUILDING, THE DIVISION OF FINANCE OR
THE PURCHASING DEPARTMENT WITHOUT BEING DATE AND TIME STAMPED OR WITHOUT
ENSURING A PURCHASING DEPARTMENT REPRESENTATIVE TAKES POSSESSION OF
SAME SHALL BE CONSIDERED NON-RESPONSIVE AND REJECTED.
ANY CLAIM BY PROPOSING ENTITY OF ERROR IN THEIR PROPOSAL MUST BE MADE
BEFORE PROPOSALS ARE OPENED, OR THE CLAIM SHALL BE DEEMED WAIVED. ANY
PROPOSING ENTITY MAY WITHDRAW THEIR PROPOSAL AT ANY TIME BEFORE THE TIME
AT WHICH PROPOSALS ARE DUE AND THE REQUEST FOR PROPOSALS IS CLOSED AND,
HAVING DONE SO, NO PROPOSING ENTITY WILL BE PERMITTED TO RESUBMIT A
PROPOSAL.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 7
1701 MOUNTAIN INDUSTRIAL BLVD, STONE MOUNTAIN, GEORGIA 30083
https://dekalbschoolsga.ionwave.net/Login.aspx
REQUEST FOR PROPOSALS
RFP 22-490
INSURANCE PRODUCER SERVICES
FOR PROPERTY AND CASUALTY
INSURANCE
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 8
TABLE OF CONTENTS
DCSD Solicitation Boilerplate ....................................................................................... 1-6
RFP Cover Page ............................................................................................................. 7
Table of Contents ......................................................................................................... 8-9
Attachments ............................................................................................................. 33-81
PART I – BACKGROUND AND INFORMATION
A. Objectives ............................................................................................................... 10
B. General Information ................................................................................................. 10
C. Procurement Process……………………………………………………………………...11
D. Addenda .................................................................................................................. 11
E. Proposal Deadlines .................................................................................................. 11
F. Schedule of Events ................................................................................................. 11
G. Format and Submission of Proposals………………………………………………..11-13
H. Virtual Pre-Proposal Conference ............................................................................. 13
I. Proposal Contact Persons ....................................................................................... 13
J. Prohibited Contacts.................................................................................................. 13
K. Questions and Answers ........................................................................................... 14
PART II – GENERAL REQUIREMENTS
A. Offeror Performance ............................................................................................... 15
B. News Release ......................................................................................................... 15
C. Non-Discrimination .................................................................................................. 15
D. Drug Free Workplace .............................................................................................. 15
E. Smoke Free Workplace .......................................................................................... 15
F. Costs Incurred ......................................................................................................... 15
G. Insurance ................................................................................................................. 16
H. Indemnification ......................................................................................................... 18
I. Illegal Immigration Reform and Enforcement Act of 2011 ........................................ 19
J. Interviews ........................................................................................................ 20
K. Contract Terms ................................................................................................. 20
L. Permits and Applicable Laws ................................................................................... 21
M. Infringement ............................................................................................................. 21
N. Ownership Rights..................................................................................................... 21
O. Non-Collusion .......................................................................................................... 21
P. Conflict of Interest .................................................................................................... 21
Q. Financial Stability…………………………………………………………………………..22
R. No Obligation/No Contract Guaranteed ................................................................... 22
S. Confidentiality and Non-Disclosure .......................................................................... 23
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 9
TABLE OF CONTENTS (CONT’D)
PART III – SCOPE OF WORK
A. Purpose/Objective/Project Overview ................................................................. 23
B. Scope of Work…..…………………………………………………….………………23-27
C. Company Profile………………………………………………………………………….27
D. Background Check……………………………………………………………………….27
E. References………………………………………………………………………………..27
F. Brochures, Catalogs, Manuals, Websites, Literature…………………………….….27
G. Added Value ..................................................................................................... 27
H. Authorization to Sell……………………………………………………………………..28
I. Evaluation Criteria ....................................................................................... 28-30
J. Payments ......................................................................................................... 30
K. Transition Plan ................................................................................................. 31
L. Required Content / Document Checklist…………………………………………. .....32
ATTACHMENTS
Attachment A – Cost Proposal Form………………………………………………........33-37
Attachment B – Insurance Producer Questionnaire……………………………………38-48
Attachment C - Information About DeKalb County School District’s
Property Insurance………………………………………………………….49
Attachment D - DeKalb County School District Insurance Policy Listings
With Premiums…………………………………………………………..50-51
Attachment E - Critical Paragraphs………………………………………………………….52
Attachment F – Offeror’s Client Reference Form………………………………………….53
Attachment G – Statement of Confidentiality and Non-Disclosure……………………….54
Attachment H – Suspension and Debarment Certification………………………………..55
Attachment I – Illegal Immigration Reform and Enforcement Act of 2011
Certification………………………………………………………………56-61
Attachment J – Standard Form Agreement……………………………………………..62-80
Attachment K – Signature Page……………………………………………………………...81
Final Page………………………………………………………………………………………82
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 10
PART I
BACKGROUND AND INFORMATION
A. OBJECTIVES
The DeKalb County School District (“DCSD”) is interested in obtaining and entering into a contract with
an insurance producer to act as DCSD’s agent/broker (“Broker”) for its property and casualty insurance
coverages/services. Due to DCSD’s unique and sophisticated insurance needs, it is critical that DCSD
has a qualified Broker working on its risk management and insurance needs. The evaluation of the
written proposals will be done by an evaluation committee selected specifically for this purpose.
The Broker will be selected based upon two criteria. The first is a review of their response to the
attached questionnaire. The second is a review of their submission of competitive proposals from
insurance companies for DCSD’s property and casualty insurance coverages.
B. GENERAL INFORMATION
DCSD is a metropolitan Atlanta public school system organized and existing under the Constitution and
laws of the State of Georgia. DCSD is located in the fourth largest county in Georgia. DeKalb County
is one of the most culturally diverse counties in the nation. DCSD has a student enrollment of
approximately 100,000 students in pre-kindergarten through grade 12. With 139 schools and centers,
DCSD educates the third largest pre-kindergarten through grade 12 student population in the State of
Georgia. DCSD is the second largest employer in DeKalb County with over 15,500 full and part time
employees.
DCSD is dedicated to giving every student the best possible education through an intensive core
curriculum and specialized, challenging instructional and career programs. DCSD is striving to become
the premier K-12 school system of choice and desires to significantly improve leadership, teaching, and
student learning to fulfill its mission as an organization for public education.
DCSD includes approximately:
• 79 Elementary Schools
• 19 Middle Schools
• 20 High Schools
• 9 Start-up Charter Schools
• 2 Conversion Charter Schools
• 13 Specialized Learning Centers
• 8 Administrative Centers; and
• 5 Athletic Stadiums
Currently, DCSD has 113 Title I Schools (110 Schoolwide and 3 Targeted Assisted). DCSD’s
wide-area network connects instruction and administration sites to deliver technology and
learning tools to every child. The main administrative offices are located at 1701 Mountain
Industrial Boulevard, Stone Mountain, Georgia 30083. DCSD is governed by a seven-member
Board of Education.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 11
C. PROCUREMENT PROCESS
The procurement will be on a formally advertised basis. Proposals must be responsive to all aspects
of this RFP.
D. ADDENDA
It is the responsibility of offerors to frequently check for any addenda, questions, and answers posted
on the Purchasing Bulletin Board on the DCSD website. Failure on the part of offerors to make
themselves aware of and comply with addenda requirements will not relieve them of this obligation, this
is a Mandatory Requirement. All posted addenda must be printed, signed by the offeror, and included
in the offeror’s RFP submission. Click on the following link to the Purchasing Bulletin Board:
https://dekalbschoolsga.ionwave.net/Login.aspx
E. PROPOSAL DEADLINES
Proposals in response to this RFP must be received by the DCSD Purchasing Department at 1701
Mountain Industrial Boulevard, Stone Mountain, Georgia 30083, no later than 2:00 PM, Tuesday,
March 29, 2022. Proposals received after the stated deadline will not be considered.
Proposals will be acknowledged publicly on Tuesday, March 29, 2022 at 3:00 PM.
F. SCHEDULE OF EVENTS
1st Consecutive Ad in Legal Organ Thursday, March 3, 2022
2nd Consecutive Ad in Legal Organ Thursday, March 10, 2022
Deadline for Offerors to Submit Questions Monday, March 14, 2022, 12:00 Noon
Posted Responses to Questions Friday, March 18, 2022, 4:30 PM
RFP Submission Deadline Tuesday, March 29, 2022, 2:00 PM
Virtual RFP Public Acknowledgment Tuesday, March 29, 2022, 3:00 PM
Responses to questions will not be posted on official DCSD holidays or furlough days.
G. FORMAT AND SUBMISSION OF PROPOSALS
The format requirements for RFP responses are designed to ensure uniformity in the responses,
provide the information necessary to understand each offeror’s proposal, and facilitate an efficient and
comprehensive evaluation of all responses. Proposals must comply with the specifications and detailed
instructions stated in this RFP document, be signed by the certifying company official, and be presented
to the DCSD Purchasing Department according to the detailed instructions stated in this document.
● Proposals must be presented in a three-ring binder with tabs separating the required sections. All
attachments must be identified properly for easy recognition and association.
Each page of the response must be numbered, and the offeror’s company name must
appear in the lower right-hand corner of each page.
● Each proposal must contain a detailed Table of Contents and must be organized in the same order
as the requirements are outlined in this RFP document. Each separate bullet point must be
addressed individually. A response that does not adhere to a “point-by-point” format may be
disqualified.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 12
● Responses shall be organized simply and economically. Emphasis must be placed on
completeness and clarity. Proposals that do not include all required information may be
disqualified.
● RFP responses must be submitted in a sealed container plainly addressed as shown below.
Containers not properly labeled as shown below will not be opened or considered.
SEE REQUIRED CONTENT / DOCUMENT CHECKLIST – PAGE 32.
Proposals must be sealed and clearly labeled and addressed as shown below:
SEALED PROPOSAL IDENTIFICATION LABEL: SEALED PROPOSAL ADDRESS LABEL:
This information must appear in the lower LEFT This information must appear in the mailing corner of your
sealed proposal container (whether address area of your sealed proposal container envelope,
box, express carrier package, etc.) (whether envelope, box, express carrier package.)
(SEALED PROPOSAL RESPONSE)
RFP Number: RFP 22-490 Insurance Producer Services for
Property and Casualty Insurance
RFP Due Date: March 29, 2022 2:00 PM (EST) (SEALED PROPOSAL RESPONSE)
Company Name: DeKalb County School District
________________________________
Purchasing Department
1701 Mountain Industrial Blvd
Company Mailing Address: Stone Mountain, GA 30083
_________________________________
ATTN: Carla L. Smith
Contact Person Name:
_________________________________
Contact Telephone No.: (__)_______________________
Email
Address:_________________________________________
Boxes, express carrier packages and any other containers enclosing sealed proposals must
ALSO be clearly labeled as shown above.
Sealed proposals MUST be received by the DCSD Purchasing Department by the DEADLINE
stated in this solicitation. Offerors submitting proposals in person must have the date and
time stamped on their sealed proposals by a Purchasing Department representative. Sealed
proposals must be placed in the care of a Purchasing Department representative.
Failure to follow these sealed proposal label and submission requirements may cause proposals to be
declared non-responsive and rejected.
Offerors are required to submit one (1) original, one (1) duplicate copy and (1) electronic copy
(flash drive) of the proposal. One (1) duplicate copy is required to be submitted with the original in
a sealed package. It is recommended that the copies be made after the original is complete and fully
executed (signed and initialed) by the offeror’s authorized representative.
The electronic copy (flash drive) shall be submitted in pdf format (OCR) and organized in the same
format as the original submission with each Chapter or Section of the original having a corresponding
Electronic File.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 13
Submit all responses to:
Carla L. Smith, Purchasing Manager
Purchasing Department
DeKalb County School District
1701 Mountain Industrial Boulevard
Stone Mountain, Georgia 30083
RFP responses will NOT be accepted at any other DCSD location.
HAND DELIVERY SUBMISSION OF PROPOSALS: Prior to the submission deadline of Tuesday,
March 29, 2022 at 2:00PM EST, an appointment must be scheduled with the Purchasing Department
by submitting an email request to solicitationquestions@dekalbschoolsga.org. Please enter “Proposal
Submission Appointment – RFP 22-490 Insurance Producer Services for Property and Casualty
Insurance” in the subject line of your email. All appointments must be scheduled on a Monday,
Tuesday, Thursday or Friday between 9:00AM-12:00PM Noon, before the March 29, 2022 proposal
deadline. A confirmation of the appointment will be sent via email.
VIRTUAL PUBLIC ACKNOWLEDGMENT: The public acknowledgment will be held virtually through
Microsoft Teams on Tuesday, March 29, 2022 at 3:00PM EST. Those who would like to attend the
acknowledgement, please register no later than Monday, March 28, 2022 by 4:00PM EST, by
sending an email to solicitationquestions@dekalbschoolsga.org. Please enter “Public
Acknowledgement - RFP 22-490 Insurance Producer Services for Property and Casualty Insurance”
in the subject line of your email. An invitation will be sent to those participants no later than Tuesday,
March 29, 2022 by 10:00AM EST.
H. VIRTUAL PRE-PROPOSAL CONFERENCE
A pre-proposal conference is not scheduled for this RFP.
I. PROPOSAL CONTACT PERSONS
The assigned contact persons for offerors are Carla L. Smith, Purchasing Manager and Phyllis Jones,
Buyer, for the Department of Purchasing. Ms. Smith can be reached at 678.676.0120 or by email at
solicitationquestions@dekalbschoolsga.org. Ms. Jones can be reached at 678.676.0285.
J. PROHIBITED CONTACTS
Except with the consent of the proposal contact person, all offerors, including any persons affiliated
with or in any way related to the offeror, are strictly prohibited from contacting DeKalb County Board of
Education members and DCSD employees or consultants on any matter having to do in any aspect
with this RFP, other than as provided herein. Any and all contacts with such persons associated with
DCSD shall be in writing, in appropriate circumstances or cases, as directed by the contact person.
Furthermore, no employee, officer, or agent of the DeKalb County Board of Education or DCSD may
participate in the selection, award or administration of a contract if he or she has a real or apparent
conflict of interest.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 14
Board Member Communication with Prospective Vendors
Vendors shall not contact Board members individually for the purpose of soliciting a purchase or
contract between the time a request for proposal is formally released and a recommendation is made
by the administration to the Board. If a vendor violates this prohibition during this timeframe,
consideration for the vendor for award shall be invalidated. Board members shall be notified of possible
violations and actions taken.
K. QUESTIONS AND ANSWERS
It is intended that this RFP be adequate for any offeror to respond to DCSD’s requirements. However,
should offerors have questions all questions shall be submitted electronically to: Carla L. Smith at
solicitationquestions@dekalbschoolsga.org. Questions submitted to any other mail box, voice mail or
e-mail address will not be considered for response. The deadline to submit questions is Monday,
March 14, 2022 by 12 Noon. Questions received after the deadline will not be considered. All
questions received by 12 Noon, on Monday, March 14, 2022 will be answered in writing and both the
questions and answers will be posted to the following website on or before Friday, March 18, 2022 4:30
PM. https://dekalbschoolsga.ionwave.net/Login.aspx .
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 15
PART II
GENERAL REQUIREMENTS
A. OFFEROR PERFORMANCE
The successful offeror is required to perform and fulfill all the undertakings, covenants, terms,
conditions, and agreements of this RFP document and any negotiated contract(s). Specifications
contained herein and in the successful response will become contractual obligations, if an award
ensues. Failure of the offeror to fully perform these obligations may result in cancellation of the award
and contract.
DCSD will look to the offeror and his/her identified personnel to coordinate and deliver the services
described in this RFP. The services shall not be delegated to subofferors or assigned to any third party.
B. NEWS RELEASE
Any news release or publicity pertaining to any phase of this project must be cleared through the DCSD
Chief Communications and Community Relations Officer.
C. NON-DISCRIMINATION
DCSD does not discriminate on the basis of race, color, religion, sex, national origin, age, or disability
in any of its employment practices, education programs, services or activities.
DCSD supports an open, fair, and impartial free-market system which maximizes competition and
seeks to include all responsible businesses and to provide ample opportunities for business growth and
development. Minority businesses are encouraged and given the opportunity to bid on various projects;
however, all responses will be evaluated on the same criteria. It is not the intention or desire of DCSD
to restrict or impede competition, nor to increase the cost of the work.
D. DRUG-FREE WORKPLACE
By submission of a response to this RFP, the offeror certifies that he/she and his/her employees shall
not engage in the unlawful manufacture, sale, distribution, dispensation, possession, or use of
controlled substance or drugs during the performance of the contract.
E. SMOKE-FREE WORKPLACE
By submission of a response to this RFP, the offeror certifies that he/she and his/her employees shall
not use tobacco products on DCSD property at any time during the performance of this contract.
F. COSTS INCURRED
DCSD is not liable for any costs incurred by an offeror in preparing and/or submitting a response to this
RFP or for any interview if requested. Any and all costs incurred by the offeror in preparing and/or
submitting a response to this RFP and interviewing with DCSD (if requested) shall be the sole
responsibility of the offeror and shall not be reimbursed by DCSD.
There is no guarantee of any offeror receiving an award as a result of submitting a response to this
RFP.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 16
G. INSURANCE
The DCSD Risk Manager sets insurance and indemnification requirements for each Solicitation.
Certificate of Insurance / Accord Form is required with solicitation submittal. Provision of
Certificate of Insurance is a mandatory requirement. Proposals submitted with certificates of
insurance will be considered conditionally responsive to the insurance and indemnification
requirement. Final award of this RFP will be contingent upon receipt within six (6) business days of
request for insurance documentation complete with the following requirements and fully acceptable
to the DCSD Risk Manager. No work will commence / no purchases will be made without the written
statement of approval of insurance coverage from the DCSD Risk Manager. In the event the
awarded offeror cannot produce insurance coverage acceptable to the Risk Manager within the
time provided, DCSD reserves the right to award this solicitation to the first runner -up.
(1) The successful Offeror shall procure and maintain throughout the term of this agreement a
policy or policies of insurance providing coverage as set forth below that shall protect the offeror
and the Indemnitees (as defined in Part II, Section I of this RFP) from any claims for bodily injury,
property damage, or personal injury which may arise out of offeror’s operations under this
agreement. The foregoing policies shall be obtained from insurance companies approved to do
business in the State of Georgia and companies acceptable to DCSD. Offeror shall procure the
insurance policy(ies) at the offeror’s own expense and shall furnish to DCSD a certificate of
insurance containing the following:
(a) Name and address of authorized agent;
(b) Name and address of insured;
(c) Name of insurance company;
(d) Description of coverage in standard terminology;
(e) Policy period;
(f) Policy Number;
(g) Limits of liability;
(h) Name and address of certificate holder;
(i) Acknowledgment to the DCSD of notice of expiration or cancellation;
(j) Signature of authorized agent;
(k) Telephone number of authorized agent; and
(l) Details of policy exclusions applicable to this agreement in comments section of insurance
certificate.
All certificates evidencing primary and excess layers shall be renewed and kept current and up to
date on an annual basis.
(2) Offeror is required to maintain the following insurance coverage during the term of this
agreement:
(a) Workers Compensation Insurance in the amounts of the statutory limits established by the
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 17
General Assembly of the State of Georgia. Offeror shall have the ability to self -insure its required
workers compensation coverage if offeror is an approved self-insurer in the State of Georgia.
(b) Comprehensive General Liability Policy, or equivalent coverage, to include products and
completed operations liability and contractual liability. The Comprehensive General Liability Policy
shall have dollar limits sufficient to insure that there is no gap in coverage between this policy and
any excess or Commercial Umbrella Policy described below.
(c) Comprehensive Auto Policy to include but not be limited to liability coverage on any owned,
non-owned and hired vehicle used by offeror or offeror’s personnel in the performance of
this agreement. The Comprehensive Automobile Policy shall have dollar limits sufficient
to insure that there is no gap in coverage between this policy and the excess or
Commercial Umbrella Policy required under this agreement.
(d) Commercial Umbrella or Excess Liability Policy, which must provide the same or broader
coverage than those provided for in the above Comprehensive General Liability and Business Auto
Policies. Policy limits for the Commercial Umbrella or Excess Liability Policy shall have an annual
aggregate limit not less than $2,000,000.
(e) Under all coverage and certificates required hereunder, policies shall or be endorsed to
include the following terms and conditions:
(i) All policies and coverage shall be on an “occurrence” not “claims made” basis.
(ii) The foregoing policies shall contain a provision that coverage afforded under the policies
will not be canceled, or not renewed, allowed to lapse for any reason until at least sixty
(60) days prior written notice has been given to DCSD.
(iii) Shall waive all right of subrogation against Indemnitees (as defined in Part II, Section
I of this RFP) for losses arising out of this agreement.
(iv) A severability of interest or cross liability clause or endorsement applies to commerci al
general liability and excess liability policies.
(v) Certificates of Insurance showing such coverage to be in force shall be filed with
DCSD prior to commencement or continuation of any work under this agreement.
(vi) All such coverage shall remain in full force and effect during the term and any renewal
thereof.
(f) Under coverage and certificates required under Sections 2(a), 2(b), (c), and (d) above,
policies shall be endorsed to include the following terms and conditions:
(i) Minimum limits of $1,000,000 per occurrence $2,000,000 in the annual aggregate.
Primary limits of coverage in the amount of $1,000,000 per occurrence must be with insurers
approved to conduct business in the State of Georgia. Excess or umbrella liability insurance
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 18
may be placed with any insurer submitted by offeror, including captive or self-insured programs,
with the prior written approval of DCSD.
(ii) Contractual liability coverage, specifically referencing this agreement and its
Indemnity, applies to liability assumed by the named insured.
(iii) Shall include Indemnitees as additional insured.
(iv) Shall waive all right of subrogation against Indemnitees (as defined in Part II, Section
I of this RFP) for losses arising out of this agreement.
(v) A severability of interest or cross liability clause or endorsement applies to commercial
general liability and excess liability policies.
(vi) Shall be primary and not excess to any other coverage provided by or available to the
Indemnitees (as defined in Part II, Section H of this RFP).
(g) Offeror shall require any and all subofferors performing work under this agreement to carry
insurance of the types and with limits of liability as offeror shall deem appropriate and adequate for
the work being performed. However, the obligations of the offeror to the Indemnitees assumed in
Sections of Indemnification, and Insurance shall not be reduced or diminished by the standards set
for the subofferors. Further, offeror agrees that their obligations to indemnify and insure the
Indemnitees shall pertain to all losses arising out of the subofferor’s acts or negligence in the same
manner and to the same extent as if committed by the offeror. Offeror shall obtain and make
available for inspection by DCSD, current certificates of insurance evidencing insurance coverage
by such subofferors.
H. INDEMNIFICATION
The successful offeror shall indemnify, defend, and hold harmless the DeKalb County School Board,
the DeKalb County School District, DCSD, and their officials, officers, employees, agents, volunteers,
and assigns (all of whom may collectively be referred to as "Indemnitees" throughout this RFP), from
any and all claims, demands, suits, actions, legal or administrative proceedings, losses, liabilities, costs,
interest, and damages of every kind and description, including any attorneys’ fees and/or litigation and
investigative expenses, for bodily injury, personal injury, (including but not limited to offeror’s
employees), or loss or destruction of property (including loss of use, damage or destruction of DCSD
owned property) to the extent that any such claim or suit was caused by, arose out of, or contributed
to, in whole or in part, by reason of any act, omission, professional error, fault, mistake, or negligence
whether active, passive or imputed, of the offeror its employees, agents, representatives, or their
employees, agents, or representatives in connection with or incidental to offeror’s performance of the
agreed-upon services regardless of whether such liability, claim, damage, loss, cost or expense is
caused in part by an Indemnitee.
The successful offeror shall also indemnify, defend, and hold harmless the Indemnitees from any and
all costs, expenses, claims, demands, rights, liabilities and causes of action inuring to offeror from
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 19
events over which the Indemnitees exercise no control, such as Acts of God, strikes or government
restrictions.
Offeror's obligation to indemnify any Indemnitee shall survive the completion, expiration, or termination
of offeror’s agreed-upon services for any reason.
I. ILLEGAL IMMIGRATION REFORM AND ENFORCEMENT ACT OF 2011 (MANDATORY
REQUIREMENT)
The Illegal Immigration Reform and Enforcement Act of 2011 applies to and is a requirement for all
DeKalb County School District solicitations for physical performance of services (i.e. public works
contracts).
Offerors must complete and/or have their subcontractors complete the following forms:
1. Immigration and Security Certification
2. Offeror E-Verify Affidavit
3. Contractor Affidavit (Contractor Only)
4. Subcontractor Affidavit (Subcontractor Only); and
5. Sub-Subcontractor Affidavit (Sub-Subcontractor Only)
The Immigration and Security Certification, the Offeror E-Verify Affidavit, the Contractor Affidavit, the
Subcontractor Affidavit and the Sub-Subcontractor Affidavit are found on pages 56-61 of this solicitation
document. The Immigration and Security Certification, the Offeror E-Verify Affidavit, the Contractor
Affidavit, Subcontractor Affidavit and the Sub-Subcontractor Affidavit must be completed, notarized and
submitted with your proposal.
I acknowledge the Illegal Immigration Reform and Enforcement Act of 2011 requirements for service
providers and confirm by my signature below that the Immigration and Security Certification, the
Contractor Affidavit, the Subcontractor Affidavit and the Sub-Subcontractor Affidavit are each
completed, notarized and made a part of this solicitation response package. I also acknowledge that
all items or services furnished to DCSD must comply with applicable federal and state immigration laws,
and regulation.
______Please check here if the Illegal Immigration and Reform Act of 2011 does not apply to your
solicitation, because it is one for items, commodities, or products. If this does not apply to any portion
of the solicitation, then the Offeror is not required to complete the Contractor Affidavit, the Subcontractor
Affidavit and the Sub-Subcontractor Affidavit found on pages 59-61. Please be advised that pages
56-58 must still be completed.
Signature of Engaging Official: __________________________________________ Date: _____________
(Company Name / Certifying Official Signature)
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 20
J. INTERVIEWS
DCSD reserves the right to require offerors to participate in one or more interviews with DCSD board
members and/or staff. Offerors must be prepared to discuss the salient points of their proposal within
two (2) normal working days of being asked to participate in interviews. There are to be no
presentations, individually or collectively, without such invitation.
Offerors who are invited to one or more interviews will be required to provide a one (1) hour virtual
presentation/demonstration of requested services.
K. CONTRACT TERMS
In the event DCSD determines that outsourcing these services are in its best interest, with the approval
of the DeKalb County Board of Education, the successful offeror will be notified in writing. A contract
confirming firm fixed price and other terms shall be signed by the parties. Services are to begin on or
about the Spring of 2022. The initial contract duration shall be approximately one year from the date
of execution. The contract may/may not contain up to four (4) one (1) year renewal
options contingent upon DCSD’s offer of such renewal, the successful offeror’s acceptance and the
approval of the DeKalb County Board of Education to extend the contract. The contract is subject to
the approval of the DeKalb County Board of Education and to fiscal year funding limitations. The
contract price must be held firm for the entire term of the contract. DCSD reserves the right to terminate
any resulting contract for convenience. In the event of contract termination by DCSD, the DCSD will
be responsible only for those services and deliverables that have been received and accepted. Any
cancellation for convenience by DCSD shall be effective three (3) business days after receipt of the
Notice of Cancellation for convenience from DCSD by the offeror. Non-performance of contract terms
shall give sufficient cause for DCSD to cancel the contract. Non-performance shall be construed to
include, but is not limited to, failure of the offeror to deliver equipment or perform services in the time
specified or in the manner required.
A contract is attached which includes all of the terms and conditions that the offeror must affirm and
comply. Refer to Attachment J, Standard Form Agreement for Non-Capital Professional
Services. Please review DCSD’s attached contract terms and conditions prior to submitting a response
to this RFP. Offerors should plan on the contract terms and conditions attached to this RFP being
included in any award as a result of this RFP. Therefore, all costs associated with complying with these
requirements should be included in any pricing quoted by the offeror.
By submitting a proposal, offeror acknowledges its acceptance of the RFP specifications and the
contract terms and conditions without change except as otherwise expressly stated in the submitted
proposal. If an offeror takes exception to a contract term or provision, the offeror must state the reason
for the exception and state the specific contract language it proposes to include in place of the
provision. Any exceptions to the contract must be submitted as an attachment to the offeror’s
response. Proposed exceptions must not conflict with or attempt to preempt mandatory requirements
specified in the RFP.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 21
L. PERMITS AND APPLICABLE LAWS
Offerors shall at their own expense obtain all necessary permits, certifications, and licenses and shall
comply with all applicable local, state, and federal laws, ordinances, rules, and regulations necessary
to the full execution of the requirements stated herein. If Offeror holds a professional certification which
is licensed by the state of Georgia, Offeror shall submit a copy of their valid professional
license. Offerors shall maintain all such permits, licenses, certifications, and compliances in a current
status throughout the course of the contract. Offerors shall submit copies of permits, licenses, and
certifications evidencing proof of the aforementioned immediately upon request of DCSD. Offerors
shall be in compliance with registration with the Georgia Secretary of State’s office as applicable.
M. INFRINGEMENT
Offeror shall fully indemnify Indemnitees against any claims of infringement of any patent, copyright,
trade secret, trademark, or other intellectual property rights related to the offeror’s response to this RFP
or services performed upon contract award. Offeror’s obligation to indemnify any Indemnitee shall
survive the completion, expiration, or termination of offeror’s agreed-upon services for any reason.
N. OWNERSHIP RIGHTS
DCSD shall retain ownership rights to the contents of all documents, supporting literature, and data
submitted by offerors to this RFP.
O. NON-COLLUSION
Offerors shall fully certify that they, as individuals or as officials of a business entity, have not entered
into any agreement, participated in collusion, or otherwise taken any action in restraint of free and
competitive responses to this RFP. Further, offerors guarantee that their response is not made in
conjunction with or on behalf of another party and that they have not been directly or indirectly induced
in any manner or taken any action to result in a restriction of trade or in an unfair advantage. Offeror
must sign below acknowledging the above statement.
Signature of Engaging Official: ___________________________________________ Date: _____________
(Company Name / Certifying Official Signature)
P. CONFLICT OF INTEREST
Offeror shall use its best efforts to disclose with their proposal the name of any officer, director, or agent
who also is a DCSD employee, agent, representative, contractor, immediate family member (spouse,
child, sibling, or parent or the spouse of a child, sibling or parent) or DeKalb County Board of Education
member. Offerors shall also disclose the name of any DCSD employee, agent, representative,
contractor, immediate family member or board member who owns, directly or indirectly, an interest in
five percent or more in the Offeror’s company or any of its branches. In the event the Offeror was aware
of a conflict of interest prior to the award of the contract and did not disclose the conflict DCSD may, at
its discretion, terminate the contract for default. The Offeror further agrees that, if after award, a conflict
of interest is discovered, an immediate and full disclosure in writing must be made to the DCSD
Purchasing Department which must include a description of the action which the Offeror has taken or
proposes to take to avoid or mitigate such conflicts. If a conflict of interest is determined to exist, DCSD
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 22
may, at its discretion, cancel the contract. Offerors shall certify that their response to this RFP is
impartial, at arms-length, and free of any conflict of interest at this time, unfair advantage, or personal
benefit to any DCSD official.
Offeror must sign below acknowledging the above statement.
Signature of Engaging Official: ___________________________________________ Date: _____________
(Company Name / Certifying Official Signature)
Q. FINANCIAL STABILITY
1. Offerors shall provide a copy of their company’s financial statements for the previous two (2)
years – for example 2020 and 2021.
2. Indicate here if your company is publicly traded or not publicly traded:
My company is publicly traded. _____/
My company is not publicly traded. _____/
3. If your company is a publicly traded company, provide a copy of your company’s annual report
for the previous two (2) years – for example 2020 and 2021.
4. List all civil and criminal proceedings your company has been the subject of, or named a party in,
and provide the outcome of those proceedings. This list should include any lawsuits, administrative
actions or litigation to which your company is currently a party or has been a party. Please explain
the basis for all claims, your response to those claims and state whether a settlement was reached
or a judgment entered.
5. State whether your company, or any affiliate currently or previously associated with your company,
has ever filed a petition in bankruptcy, taken any actions with respect to insolvency, reorganization,
receivership, moratoriums or assignment for the benefit of creditors, or otherwise sought relief from
creditors.
6. State whether your company was the subject of any order, judgment or decree not subsequently
reversed, suspended or vacated by any court permanently enjoining your company from engaging
in any type of business practice.
R. NO OBLIGATION/NO CONTRACT GUARANTEED
This RFP does not commit DCSD to contract with any offeror to this RFP. There is no guarantee of any
offeror receiving an award or contract as a result of submitting a response to this RFP.
Offeror must sign below acknowledging the above statement.
Signature of Engaging Official:_____________________________ Date: _____________
(Company Name / Certifying Official Signature)
S. CONFIDENTIALITY AND NON-DISCLOSURE (MANDATORY REQUIREMENT)
Information made available to offerors by DCSD shall be used only for purposes related to responding
to this RFP and shall not be used for any other purpose without the express written permission of
DCSD.
Offerors to this RFP unequivocally agree to assume responsibility for protecting and safeguarding the
confidentiality of DCSD records that are not public information. Such information may include, but is
not limited to student and human resource file contents.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 23
Part III
SCOPE OF WORK AND REQUIREMENTS
A. PURPOSE / OBJECTIVE / PROJECT OVERVIEW
The DeKalb County School District (“DCSD”) is interested in obtaining and entering into a
contract with an insurance producer to act as DCSD’s agent/broker (“Broker”) for its property
and casualty insurance coverages/services. Due to DCSD’s unique and sophisticated insurance
needs, it is critical that DCSD has a qualified Broker working on its risk management and
insurance needs. The evaluation of the written proposals will be done by an evaluation
committee selected specifically for this purpose.
The Broker will be selected based upon two criteria. The first is a review of their response to the
attached questionnaire. The second is a review of their submission of competitive proposals
from insurance companies for DCSD’s property and casualty insurance coverages.
With respect to the second criteria, due to the conceptual nature of submittals anticipated in
response to this RFP, the insurance programs are not to be marketed by respondents at this
time. Blocking or reserving insurers prior to award of this contract is prohibited. Brokers should
not apply for insurance on behalf of the DCSD in a manner that would obligate the insurer to
provide quotes exclusively to that Broker prior to award of a contract and the provision of
insurance specifications. Failure to comply with the above referenced guidelines may be
grounds for disqualification.
The relationship between the Broker and DCSD’s Risk Management Department is one of
shared activities. The goal is the effective use of talents to achieve the most favorable results
for DCSD.
The leadership of DCSD, and its residents, have an interest in assuring a fair, equitable
relationship with the Broker. Therefore, it is in the best interest of DCSD to establish a reputation
of professionalism and stability when managing DCSD’s insurance program.
With that in mind, after the award of the contract, the Broker must shop the market for competing
insurance proposals every year. Additionally, DCSD reserves the right to negotiate directly with
any insurance companies, underwriters or suppliers that are willing to do so. This is especially
the case when there is an emergency need for coverage or when the anticipated premium for
the coverage is so small as to not require or justify a formal solicitation between the competing
firms.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 24
Currently, DCSD purchases the following insurance policies and bond coverage: property and
fine arts; excess workers’ compensation and employers’ liability reimbursement; student blanket
professional liability; pipe organ, governmental crime; superintendent’s bond; leased warehouse
and leased parking lots; leased equipment, special events liability; and special purpose
insurance policies. See Attachment “D,” DeKalb County School District Insurance Policy Listings
With Premiums (pages 50-51). That attachment is as of February 10, 2022, and provides
information and history of insurance purchased since 2018.
B. SCOPE OF WORK
Offerors responding to this RFP are encouraged to be very specific and detailed in their
responses to the following Scope of Work. Responses to this RFP will be evaluated for quality,
comprehensiveness, and deliverables meeting the following scope of work and criteria. Please
submit your response labeled: Project Scope of Work.
DCSD is interested in a Broker who will seek competitive, bindable insurance quotes for DCSD’s
major lines of property and casualty insurance business by soliciting insurance quotes and
presenting proposals on DCSD’s property and casualty insurance coverages/services. The
Broker selected will depend on the quality of the proposal received and the areas of
specialization. The Broker selected must have a local office that will provide personnel support
and the bulk of services to DCSD. A national office, however, may support the local efforts.
First, the Broker will be evaluated based upon their responses to the attached questionnaire.
The Broker should be qualified in the following three areas:
• Major property insurance,
• Casualty insurance having, net of commissions, anticipated premiums of $100,000 or more,
and
• Casualty insurance policies having, net of commissions, anticipated premiums of less than
$100,000.
Second, the Broker will then present competitive quotes for evaluation, from qualified insurance
companies, that apply to DCSD's property and casualty insurance program needs. As a part of
this second evaluation process, the Broker must not apply for insurance in a manner that would
obligate the insurer to provide quotes exclusively to that Broker (or otherwise “block markets”)
before the formal release of a written request for the coverage. The primary objective is to obtain
for DCSD, on a competitive basis, quality insurance coverage at a cost commensurate with the
amount and quality of coverage.
Once the Broker is selected and a contract is executed, then the Broker will obtain, at the time
needed, competitive quotes of a specific line or lines of coverage. Of course, after the contract
between the Broker and DCSD is signed, then the Broker may approach the same insurance
carriers for the coverages needed. After the contract is executed, if requested by an insurance
carrier, the Broker will be provided with a “Broker of Record” letter.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 25
Reservations of Rights: DCSD also purchases several smaller, special purpose polices through
various vendors and with various renewal dates. Often these need to be procured on short
notice. At times they are procured through associations or specialized programs to insure a
specific type of risk exposure. These special-purpose policies (which include special events
insurance, program-specific liability policies, and individual location policies, for example) are
also covered by this RFP. DCSD, however, reserves the right to obtain these special-purpose
policies outside this RFP relationship or, alternatively, to make arrangements with the selected
Broker, as best suits the needs of DCSD at the time of procurement or renewal.
While it is expected, during this second stage of the evaluation, that the Broker will identify
uninsured, under insured, and over insured risk exposures, should DCSD accept
recommendations and attempt to secure additional insurance coverage for the exposures,
DCSD reserves the right to seek competitive proposals from other sources. In addition, DCSD
reserves the right to accept the proposal deemed to be in the best interest of the DCSD.
Services to be provided: In the solicitation of insurance quotes, the Broker will carry out the
typical role of an insurance producer. Services will include, but are not limited to:
• Recommend, review, and understand DCSD’s insurance specifications;
• Advise DCSD annually which insurance policies should be renewed through the existing
insurer, and which should be renewed competitively in order to optimize stability and
long-term premium costs;
• Provide DCSD annually with results of inquiries throughout the insurance marketplace
of quotes for insurance even if the recommendation is to renew through the existing
insurer;
• Consult with DCSD designated staff to formulate a marketing strategy that focuses on
delivering a cost-effective risk management strategy and structure based on current
market conditions;
• Work with DCSD staff on loss prevention and cost cutback plans;
• Agree upon and meet DCSD’s schedules for submissions and other work products;
• Schedule work activities to procure quotes for expiring insurance policies in adequate
time for them to be evaluated and properly approved in a timely fashion (Special Note:
The Broker shall monitor the expiration date of existing insurance policies and provide
DCSD’s Risk Management with a formal report. The target date for submission of this
formal report shall be three months in advance of the renewal date. If that is not feasible,
the Broker must communicate in writing the reasons it is not feasible and must provide
a firm commitment as to the date the report will be delivered.);
• Suggest innovative coverage and risk financing solutions to reduce DCSD’s cost of risk;
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 26
• Identify and approach potential insurance markets that may be interested in quoting;
• Complete any necessary insurance applications, based on information and data
provided by DCSD;
• Stay in contact with underwriters and DCSD’s Risk Management Department to answer
questions and to “sell” DCSD to the insurance company’s underwriting unit;
• Obtain and document to DCSD all quotes and declinations the Broker receives;
• Analyze all quotes received;
• Prepare and present in writing and verbally a formal insurance proposal with the
producer’s top five received quotes. The proposal should include an analysis as to why
the producer ranked the competitive quotes one through five;
• Following-up to bind coverage and obtain the policies that are accepted;
• Annually, by February 10 of each year, provide (based on current insurance market
trends) an estimate for budgetary purposes of the anticipated renewal cost of each
DCSD policy serviced by the firm;
• Identify risks faced by DCSD and formulation of suggested strategy for reduction of those
risks by means other than the purchase of insurance;
• Provide mitigation of loss services to DCSD; and
• Assist, if requested, with claims submission on various insurance policies and with the
tracking and record keeping of the claim outcome for future reference. DCSD will handle
in-house the claims administration.
Additionally, the Broker awarded the contract will assist DCSD by reviewing DCSD’s buildings and
classifying, for those which have not yet been classified, according to standard ISO Construction
Codes.
The Broker contracted should submit in advance of quote solicitations an insurance marketing plan.
When competitive proposals are obtained and submitted, the Broker should provide an analysis of each
as to quality of the insurance policy and the cost effectiveness. The Broker should then recommend
which of the offers would be most advantageous to DCSD.
The Broker should also submit a record of all insurance markets approached, the responses by each
insurer, and the reason (if known) for all declinations.
Once a Broker has obtained a policy of insurance for DCSD, then any subsequent Broker will fulfill all
the duties and responsibilities that are standard for the industry or required by insurance regulations.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 27
Additionally, the subsequent Broker will provide any additional services that were offered in the
original Broker proposal provided and accepted.
C. COMPANY PROFILE
Offerors to this Request for Proposal are required to demonstrate, and include with their submissions
to this RFP, a full and complete company profile, to include, but not be limited to: the date of
establishment, mission statement, type and confirmation of company’s legal entity form, company’s
organizational structure/chart, principals’ names and titles, company size in relation to industry, number
of employees, company history, financial position, and all relevant current and past experience on
similar projects in comparable K-12 school districts and references for those projects. The offeror
should also include the educational background for staff that will be assigned to this project, including
the company’s overall experience in providing the requested services within this solicitation.
D. BACKGROUND CHECK
A criminal background check must be performed on all contractors, consultants, subcontractors,
volunteers and vendors (hereinafter jointly referred to as "Individuals") who provide services on DCSD
premises, supervise services on DCSD premises, or has contact with students. These Individuals shall
undergo the same criminal background check, within the last 365 days, as required by DCSD
employees. Such background checks will be performed by DCSD at the expense of the Individual at a
cost of $45.00 per individual. Additionally, any charges against the Individual, may be deemed
unacceptable in DCSD’s sole discretion regardless of whether dismissed, expunged, sealed, removed
from the record, treated as a “first offender” or dead docketed. Upon receipt and evaluation of DCSD’s
background check results, DCSD may demand that the Individual have no contact with DCSD students
or parents, or provide services to DCSD premises. Any failure of the contractor to obtain a criminal
records background check through DCSD, as stated herein, may result in termination of any resulting
contract between contractor and DCSD.
E. REFERENCES (MANDATORY REQUIREMENT)
Offeror must provide the names and contact phone numbers of at least three (3) current clients,
preferably clients comparable to DCSD, for whom the offeror is providing or has provided services as
defined within the scope of work. Refer to Attachment F – Offeror’s Client Reference Form, (page 53).
References will be contacted.
F. BROCHURES, CATALOGS, MANUALS, WEBSITES, LITERATURE
In addition to the formal response to this RFP, all offerors are encouraged to submit brochures,
catalogs, manuals, website materials, industry literature, DVD’s and any other marketing and
informational media which will support and enhance their submission value.
G. ADDED VALUE
Offerors are encouraged to describe in detail all added value or additional services or benefits available
and offered at no cost to DCSD in their RFP responses. Attach and label as “ADDED VALUE.”
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 28
H. AUTHORIZATION TO SELL
Offerors responding to this RFP must provide a Certificate of Authorization that authorizes offeror to
sell the manufacturer’s equipment, if applicable.
I. EVALUATION CRITERIA
DCSD advertises this RFP as an opportunity for interested and qualified firms specializing in providing
services to submit responses consistent with the scope of work stated herein. Offerors to this RFP are
encouraged to submit their most comprehensive, innovative and creative proposals for DCSD.
DCSD may, at its sole discretion, select or reject all or portions of the service(s) proposed from
responsive and responsible offerors. As a part of the evaluation process, DCSD may find it necessary
to evaluate the addition or deletion of components of an offeror’s proposal in order to make equivalent
comparisons to other proposals. DCSD will select the offeror whose proposal DCSD determines best
meets the needs of DCSD, based on the requirements and evaluation criteria set forth herein.
The determination of the successful proposal will be based upon information supplied by the offeror in
the RFP response and upon other information that will be obtained by DCSD as it deems necessary.
Proposal conformance to RFP instructions, terms, conditions, and requirements is critical to offeror
responsiveness.
The lowest-cost proposal submitted may not necessarily be determined to be the most responsive
and responsible proposal when all factors have been considered. However, the quoted price is an
important factor in the determination of the selected proposal.
All responsive offerors will be carefully reviewed and evaluated for responsibility, capacity, business
strength, qualifications, expertise, demonstrated experience in providing insurance producer services
for property and casualty insurance for large urban public school districts and highest and best value
to DCSD with consideration to quality, approach, timeliness, dedicated personnel, and added value
(if any). Proposal conformance to RFP instructions, terms, conditions, and requirements is critical to
offeror responsiveness.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 29
CRITERIA FOR SELECTION
Insurance Proposals will be evaluated based on qualifications and coverage proposals. The
maximum total overall score is 200 points. The criteria are as follows:
First Criteria – Insurance Producer (“Broker”) Qualifications (the purpose of this RFP)
Relative Evaluation Criteria
Weight
(Points) Score
50 Agency and Personnel Qualifications
• Qualifications and experience of Account Team including Support Staff
• Size of Agency and ability to service DCSD’s needs;
• Adequate insurance coverage;
• In good standing with the Office of Insurance and Fire Safety
Commissioner;
• Convenience of Office location to DCSD headquarters;
• References; and
• Fees/Costs billed to DCSD
25 Marketing Services
• Access to Excess & Surplus markets and Lloyds;
• Knowledge of and experience with major rating plans and/or programs; and
• Quality of Major Markets represented.
15 Special Insurance Needs
• Exposure Identification;
• Loss Control/Safety;
• In-house based loss recording and analytical system;
• Loss frequency and severity forecasts;
• Loss development and trending analysis;
• Property valuation;
• Establish “Maximum Foreseeable Loss" and "Probable Maximum Loss"
estimates;
• Actuaries on staff; risk and loss control services;
• Providing training in risk and loss control; and
• Claims administration.
10 Quality of the written submission
• Clearly written;
• Responsiveness to instructions;
• Brevity; and
• Completeness.
100 TOTAL SCORE
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 30
Second Criteria – Broker’s Insurance Coverage Proposals (for future reference)
Relative
Weight
(Points) Evaluation Criteria Score
40 Coverage Quality
60 Net Cost* to DCSD – including premiums, commissions, fees, and premium
taxes.
100 TOTAL SCORE
DCSD prefers payment on a flat fee basis and anticipates that the Broker selected will be fully
compensated on a flat fee basis. However, Brokers may propose to work on another basis when
submitting the insurance proposals. In that case, please explain the basis (commission, fee for
specific services, or some combination) on which you propose to be compensated for the
services to be performed under the contract.
Answers to these questions will clarify the proposals submitted by the Broker: Are there
limitations on the number of hours or the services that DCSD can access? What are the reasons
for not submitting a proposal based upon a flat fee? If commission is contemplated, how is the
commission determined? Will you agree to transparency with respect to all commissions paid?
Please indicate clearly if any anticipated services will require additional compensation beyond
the base commission or fee and, if so, the cost for such additional service.
* Net Cost will be determined on an item-by-item basis. The goal is to select one Broker to handle all
the insurance needs of DCSD. There is no guarantee, however, that any one Broker will be awarded
all lines of business. DCSD will entertain quotes for multiple lines of coverage but is under no obligation
to accept any. As stated above, DCSD prefers payment to one Broker who is selected to handle all
insurance needs on a flat fee basis that will be paid quarterly throughout the fiscal year.
J. PAYMENTS
Offerors must provide a firm fixed price for the entire project. By submitting a response to this Request
for Professional Services, the successful offeror agrees that if the offeror does not complete the project
on a mutually agreed terms, at DCSD’s sole election, DCSD may terminate any remaining obligation
for performance under the agreement or contract; at DCSD’s sole election, any agreement or contract
will be terminated without recourse. DCSD, at its sole option, will have the right to seek a new offeror
to perform the required services.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 31
K. TRANSITION PLAN
Transition on Commencement of Contract
The awarded offeror shall assume full services in accordance with the award of the RFP. The awarded
offeror shall coordinate and cooperate with DCSD’s existing provider(s) to ensure a smooth and orderly
transition with uninterrupted services.
Transition and Continuity of Service upon Expiration of Contract. Continuity of services is
necessary to DCSD. The awarded offeror agrees to this philosophy and upon expiration of contract,
agrees to:
• Exercise best efforts and cooperation for an orderly and efficient transition to another provider
or to DCSD.
• Negotiate a plan in good faith with successor to determine the nature and extent of the phase-
in, phase-out services required. The plan shall specify a date for services described in the
plan and shall be subject to approval by DCSD. The existing service providers shall provide
sufficient experienced personnel during the phase-in and phase-out periods to ensure that
the imperious services in the contract are maintained at the required level of need and
proficiency.
• All DCSD property (including but not limited to, students and DCSD records, parts,
equipment, facilities, keys and materials) shall be returned to DCSD upon expiration of
contract.
• Offeror shall include in their response any DCSD or any subsequent contractor requirements, if
offeror is awarded this contract and does not retain this contract upon its expiration.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 32
L. REQUIRED CONTENT / DOCUMENT CHECKLIST
IMPORTANT NOTICE: Failure to provide the information and/or documentation required in
this solicitation may cause the submission to be declared non-responsive and rejected.
Refer to Part I, Section G, Page 11, for additional information on the format and submission of proposals.
Offerors are required to submit one (1) original, one (1) duplicate copy and one (1) electronic copy (flash
drive) of the proposal of their response. Responses must be submitted on 8 ½” x 11” single-sided stock.
All RFP submissions must include the following items and attachments.
The Request for Proposals document, RFP 22-490 Insurance Producer Services for Property
and Casualty Insurance, MUST BE the first document in the submission; this document
consists of 82 pages and is located at https://dekalbschoolsga.ionwave.net/Login.aspx1
Table of Contents for your submission
• Addenda – Each individual Addendum must be printed, signed and inserted immediately
following the Table of Contents (Mandatory Requirement)
• Certificate of Insurance (Mandatory Requirement)
• Company Financial Statements and Company Annual Reports
• Attachment A – Cost Proposal Form (Mandatory)
• Attachment B - Insurance Producer Questionnaire (Mandatory)
• Attachment E – Critical Paragraphs (Mandatory Requirement)
• Attachment F – Offeror’s Client Reference Form (Mandatory Requirement)
• Attachment G - Statement of Confidentiality and Non-Disclosure (Mandatory Requirement)
• Attachment H – Suspension and Debarment Certification (Mandatory Requirement)
• Attachment I – Immigration & Security Certification (Mandatory Requirement)
• Attachment K – Signature Page (Mandatory Requirement)
• Company Profile
• Brochures, Catalogs, Manuals, Websites, Literature, DVDs and other marketing media
• Project Scope of Work
• Added Value
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 33
Attachment A
RFP 22-490
Insurance Producer Services for
Property and Casualty Insurance
Cost Proposal Form
The insurance producer offeror (“Broker”) must be willing to honor this fee proposal for up to 60 months
after the DeKalb County Board of Education approval and acceptance of this RFP. The agreed upon
fee will be reflected in the contract executed by DCSD and the Broker.
Each successful Broker responding to this RFP for Insurance Producer Services will furnish all labor,
travel, resources, materials tools, equipment, and services required to satisfactorily complete the Scope
of Services requested in this RFP for the total cost as stated below. Total cost shall include all labor,
materials, tools, specialized equipment, supplies, trained personnel, insurance, travel and per diem,
direct and indirect administrative costs, overhead, any other charges, and all things and services
necessary to provide Insurance Producer Services for Property and Casualty Insurance, in accordance
with the requirements of this RFP.
All costs listed below are inclusive. DCSD will not be responsible for charges that are not included on
this Cost Proposal Form. DCSD prefers an annual fixed fee for services rendered; however, alternative
cost proposals may be submitted as shown below.
Categories of Insurance Coverage Proposed for Qualification of Broker
Qualification of Brokers is preferred for all three categories below. Any combination, however, thereof
will be considered:
• Major property insurance;
• Casualty insurance having, net of commissions, anticipated premiums of $100,000 or more;
and
• Casualty insurance policies having, net of commissions, anticipated premiums from $50,000
through $99,999.
Note: The premiums noted in Attachment “D,” DeKalb County School District Insurance Policy Listings
with Premiums, are gross premiums. No fees are included on Attachment “D” for Broker services which
are paid separately.
Check the category(ies) of Insurance Coverage for which you wish to be considered:
⃝ 1. Major property insurance
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 34
⃝ 2. Casualty insurance having, net of commissions, anticipated premiums of $100,000 or
more
⃝ 3. Casualty insurance policies having, net of commissions, anticipated premiums of less
than $100,000.
Is your proposal contingent on your firm being the selected producer for two or more the categories
above you have checked? __________ NO ____________ YES
If you answered “YES”, please state the Insurance Coverage categories that must be awarded together
for your proposal to be valid:
Special Note: If you are proposing for two or three different categories of Insurance Coverage and not
requiring that they all be awarded together for the proposal to be valid, then please attach a separate
statement. That statement should indicate the discount (if any) off the Proposed Annual Fees stated
below which you will offer DCSD if awarded more than one category of coverage.
If proposing an annual fixed fee for services as preferred by DCSD, then please complete the two
blanks in each of the three categories below with the dollar amounts to be charged. The total annual
fixed fee will be achieved by adding together the amounts listed in all three categories and should be
listed by the Broker in number four below. If proposing some alternative cost structure, write on the
first line “See Proposed Alternate Cost Structure Attached.”
1. Major Property Insurance, Proposed Annual Fee:
$________________________________________________________________________ (in figures)
Dollars ($) ________________________________________________________________ (in words)
2. Casualty Insurance having, net of commissions, Anticipated Premiums of $100,000 or
more; Proposed Annual Fee:
$_________________________________________________________________________ (in figures)
Dollars ($) _________________________________________________________________ (in words)
3. Casualty Insurance having, net of commissions, Anticipated Premiums of less than
$100,000; Proposed Annual Fee:
$_________________________________________________________________________ (in figures)
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 35
Dollars ($) __________________________________________________________________ (in words)
4. Total Proposed Annual Fee for all Insurance stated in 1 through 3 above:
$ _________________________________________________________________________(in figures)
Dollars (4)___________________________________________________________________(in words)
Proposed Fixed Cost Structure
If you proposed compensation above on a fixed fee for the Scope of Work described in the RFP.
Please attach a statement to clarify the following points:
1. Please indicate clearly if there are any anticipated services will require additional compensation
beyond the stated fixed fee and, if so, the cost for such additional services.
2. Kindly advise as to whether there are any limitations to the numbers of service hours DCSD will
provided for these services?
3. The original annual contractual agreement may be for one year. That contract will allow DCSD to
exercise and renewals for up to four (4) additional years. Explain for how many renewals the fixed
annual fee will remain stable. If there is a limit of stability to less than four extensions, please state
how will further renewal fees be determined?
4. On occasion, DCSD probably will need to procure some additional type of insurance coverage than
those currently in place or for which Broker has not been assigned to provide. If your firm is asked
to procure such insurance, are you willing for the specific policies in question to be compensated
on the existing fixed fee bases reflected in the contract or will commission by the insurer be
required?
Proposed Alternate Cost Structure
It is anticipated that the Broker whose proposal is accepted will be fully compensated on a fee for
services basis. However, the Broker may propose to work on another basis when submitting the
insurance proposals.
If that is the case, please explain the basis (commission, fee, or some combination) on which you
propose to be compensated for the services to be performed under this contract. Are there limitations
on the number of hours or the services that DCSD can access? If commission is contemplated, how
is the commission determined? Will you agree to transparency with respect to all commissions paid?
Please indicate clearly if any anticipated services will require additional compensation beyond the base
commission or fee and, if so, the cost for such additional service.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 36
The alternate cost structure must be clearly described to demonstrate advantages to DCSD versus a
fixed cost structure. As stated above, DCSD prefers a fixed cost structure.
Proposed Fee Payment Schedule
Please attach a narrative that describes the frequency and the dollar amount of payments you wish to
receive over a 12-month period. Bear in mind that DCSD prefers a quarterly payment of the total fixed
fee made to the Broker over the fiscal year.
Please review and complete the following as part of the Cost Proposal Form.
Complete the following and submit with Cost Proposal Form.
_______________
Company Name
_______________
Authorized Company Representative Name (please print) Title
_______________
Authorized Company Representative Signature Date
_____________________________________________________________________
Address
_____________________________________________________________________
Phone Fax
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 37
Special Additional Insurance Services Available
Below is a column listing “Additional Services” which DCSD may or may not need. These are services deemed
to be beyond the minimum “Scope of Work” requirements. For each Additional Service listed, check if your firm
can offer this service. If you do have the service available, check the appropriate column to indicate whether
the service is included in your proposal at no additional cost or if it is available for purchases at an additional
cost. Finally, provide as an attachment a brief narrative which describes the amount of service included in the
proposed fees or the basis for calculation of any additional fees for these services. You may
add up to three additional services if you wish.
Additional Check if Check if Check if Descriptive
Services Available included in Available but Narrative
Possibly the Cost at an attached
Needed Proposal at Additional
No added Invoiced Cost
Cost
Exposure ⃝ ⃝ ⃝ ⃝
Identification
Loss Control/ ⃝ ⃝ ⃝ ⃝
Safety
In-house based ⃝ ⃝ ⃝ ⃝
loss recording
and analytical
System
Loss ⃝ ⃝ ⃝ ⃝
Development
and trending
analysis
Property of ⃝ ⃝ ⃝ ⃝
Valuations
Estimates of ⃝ ⃝ ⃝ ⃝
“Maximum
Foreseeable
Loss” and
“Probable
Maximum Loss”
Actuaries on ⃝ ⃝ ⃝ ⃝
staff, risk, and
loss control
services
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 38
Providing ⃝ ⃝ ⃝ ⃝
training in risk
and loss control
Claims ⃝ ⃝ ⃝ ⃝
administration
Other Services ⃝ ⃝ ⃝ ⃝
Offered:
⃝ ⃝ ⃝ ⃝
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 39
ATTACHMENT B
RFP 22-490
Insurance Producer Services for
Property and Casualty Insurance
INSURANCE PRODUCER QUESTIONNAIRE
Complete this questionnaire based on the activities of your local office unless the instructions
provide otherwise. If expertise from other offices will be available and/or necessary in servicing our
requirement, please specify these services, the offices, and personnel to be involved. Do not
include the services of any insurance companies unless your agency owns the company or has a
contract with the company to provide the services for clients such as DCSD. Include a copy of your
annual report when returning this questionnaire, and any other material describing your services
and organizations that you believe may be appropriate. Also, please include references as in the
format shown in Attachment “F,” Offeror’s Client Reference Form.
Special note: It is anticipated and preferred that DCSD deal directly with one insurance producer
(“Broker”), that will provide all the insurance services needed (especially the insurance marketing
services) that are anticipated in the proposals submitted. The Broker selected will be qualified as
evidenced by the response to this questionnaire. However, joint ventures; partnerships; and the
use of subcontractors are not precluded from consideration. If such a multi-organization
arrangement is proposed, such must be fully described in the proposal submitted, and each
member firm of the total organization must be identified and evaluated for the services it is to
provide. In that case, the lead organization must complete fully this Attachment “B,” Insurance
Producer Questionnaire, and each additional organization to be significantly participating in this
project must also complete it to the extent that the items below apply to the services that Broker
will be providing. Please mark as “N/A” all the items that do not apply to the services the specific
partner in this proposal will provide.
The Broker selected pursuant to this RFP will evaluated on two criteria. The completion of this
questionnaire is needed for evaluation of the first criteria. For the second criteria, a review is
conducted of the Broker’s submission of competitive proposals from insurance companies for
DCSD’s property and casualty insurance coverages.
Date:
1. Name of Firm:
________________________________________________________________________________
2. Categories of Insurance (Please note that the answer to question 2. and the response to the
check list on the top of Attachment A, “Cost Proposal Form” (pages 33-37) should be the same.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 40
In the event of a conflict between the Cost Proposal Form and the answer to this question 2, the
signed Cost Proposal form shall prevail.)
Check all the categories of insurance you propose to pre-qualify to produce:
___ Major property insurance;
___ Casualty insurance having, net of commissions, anticipated premiums of $100,000 or more;
___ Casualty insurance policies having, net of commissions, anticipated premiums of less than
$100,000.
Is your proposal contingent on your firm being selected producer for two or more of the
categories that you have checked? ___ Yes ___No
If you answered “Yes”, please state the Insurance Coverage categories that must be awarded
for your proposal to be valid:
___________________________________________________________________________
Addresses and locations of all Offices (use separate sheets if necessary and identify the “home”
office.)
Telephone Number of Local Office:
Fax Number of Local Office:
Date Firm Established:
3. Names of local office principals, their experience, and professional qualifications: (use separate
sheets if necessary)
3.1
3.2
3.3
4. Names of personnel (including support staff) that will be assigned to the account:
Years with your firm and in the insurance industry (use separate sheet if necessary)
4.1
4.2
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 41
4.3
If selected, what type of guarantee can you give the DCSD Risk Management Unit that
(excluding resignation, termination, promotion, or transfer) the personnel assigned to our account
will continue to service our account?
________________________________________________________________
________________________________________________________________
________________________________________________________________
5. How many employees in local office?
5.1 Number Designated CPCU ARM Other ______
6. Annual gross income of your local office regarding governmental entities:
6.1 Premiums (if applicable)
6.2 Commissions (if applicable)
6.3 Fees (if applicable)
6.4 Other
7. State the insurance coverages, limits, and current insurer your firm will carry during the duration
of the contract to protect your company and your clients, as follows:
7.1 Insurance Producer Errors & Omissions
General Liability
Auto Liability
Employee Dishonesty Bond Workers'
Compensation
(Please note that the limits must at least equal the minimum coverage specified
elsewhere in this RFP. Consideration will be given to relevant insurance that exceeds the
minimum required.)
7.2 Will you add the DCSD as additional insured to all the above policies except the insurance
producer E&O, employee dishonesty bond, and workers' compensation?
Yes No (Explain why not) _____________
8. Have any of the agents/brokers currently in the local office ever had their
insurance license suspended or revoked, or is any action currently pending with
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY
INSURANCE PAGE 42
the Georgia Insurance Department? (If yes, please explain
9. Do all the employees in your office meet the licensing requirements of the
Georgia Insurance Department, if so required? (If no, please explain)
________________________________________________________________
________________________________________________________________
10. Based on your current knowledge of the DCSD, state the titles of the positions and
your estimate of the number of days that will be required by your staff annually to
meet the Scope of Work.
Title/Position Estimated Maximum
Number of Days
TOTAL
11. Exposure Identification Services:
11.1 Please describe your specific techniques and procedures which may be
used to assist DCSD’s Risk Management Unit in identifying current and
anticipating new exposures to accidental loss and whether insurance
provided by your firm covers these exposures.
11.2 Can Loss Control/Safety Inspections be made by your staff?
Yes No _________________
11.3 If you do not have in-house loss control/safety personnel, do you have an
………arrangement with an outside firm? ________ If so, please give their name
………and qualifications.
12. Risk Evaluation Services:
12.1 Although DCSD provides its own in-house claims
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY
INSURANCE PAGE 43
administration, do you have any claims staff that could assist, if needed,
with the submission of a claim to an insurance carrier and the record
keeping of those claims for future reference as needed for any renewal
review?
12.2 Can your firm provide a claims audit of our workers’ compensation and
liability files? Note: This question is an inquiry as to Broker’s capabilities to
provide a claims audit. DCSD may or may not request actual audits
depending on future circumstances.
Yes __________ No __________
Describe: ___________________________________________________
12.3 Can you provide loss frequency and severity forecasts?
Yes __________ No __________
Describe: ___________________________________________________
12.4 Can you provide loss development and trending analyses?
Yes __________ No __________
12.5. Do you provide property valuation services?
Yes __________ No __________
Describe: ___________________________________________________
12.6 Can you establish and/or review property "maximum foreseeable loss" and
"probable maximum loss" estimates?
Yes __________ No __________
Describe: ___________________________________________________
13. Risk and loss control services:
13.1 Describe your internal loss prevention engineering capabilities, including
number of specialists, their areas of expertise, their availability, and their
cost. Specify any added services you offer to provide at no additional cost.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY
INSURANCE PAGE 44
Fire Prevention
Boiler & Machinery
Personnel Safety
Industrial Safety
Industrial Hygiene
Commercial Auto Fleet Safety
Environmental Protection
Security
Police Services
Recreational Activity Safety
Cost Cut-Back Plans
Other
13.3 Can your staff provide training services in risk and loss control?
Yes __________ No __________
Describe: ___________________________________________________
14. Insurance Marketing Services:
14.1 Is your access to the excess or surplus lines market via:
(a) Your own organization?
__________________________________________, or
(b) An outside agency?
____________________________________________
If external, which one(s)?
____________________________________________
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
14.2 Which Lloyd's broker(s) do you use?
___________________________________________________________
______________________________________________________________________
________________________________________________
14.3 Describe your capabilities and experience in:
Wrap-Up Projects, Owner Controlled or Contractor Controlled Insurance programs
___________________________________________________________
___________________________________________________________
Self-Insurance Plans
___________________________________________________________
___________________________________________________________
Self-Insurance Pools
___________________________________________________________
___________________________________________________________
Layering of Insurance Coverages
___________________________________________________________
___________________________________________________________
Risk Retention Groups
___________________________________________________________
___________________________________________________________
15. Major insurance markets: (Please indicate the principal insurance companies used by your local
office)
Property Insurance Market Estimated Annual Premium Volume
December 31, 2020
1.
2.
3.
Liability Insurance (Auto, General, Estimated Annual Premium Volume
Law & Educators’ Legal Liability, December 31, 2020
D&O, EPLI)
1.
2.
3.
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 46
Excess Liability Insurance Estimated Annual Premium Volume
December 31, 2020
1.
2.
3.
Excess Workers' Compensation Estimated Annual Premium Volume
December 31, 2020
1.
2.
3.
Fiduciary Liability Insurance Estimated Annual Premium Volume
December 31, 2020
1.
2.
3.
16. Please list the major insurance markets your company most frequently uses to provide quotes
for the following types of coverage:
Property Insurance
1.
2.
3.
Fiduciary Liability Insurance
1.
2.
3.
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 47
Excess Liability Insurance
1.
2.
3.
Excess Workers' Compensation
1. ________________________________
2. ________________________________
3. ________________________________
Crime Insurance
1.
2.
3. ________________________________
17. Do you provide insurance producer services for any school districts that have over 10,000
employees and an operating budget over $1,000,000,000? If so, how many?
________________________________________________________________
17.1 Please list the school districts in Georgia that you provide insurance producer services,
for any size or any operating budget.
________________________________________________________________
17.2 For those school districts listed in response to 17.1 above, please provide a brief
description of the types of insurance products you provide.
________________________________________________________________
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 48
18. From time-to-time, DCSD or specific District facilities will need small insurance policies for
specific, special purposes (special events, liability insurance to meet a specific landlord’s needs,
trip insurance, student blanket professional liability insurance, etc.). Describe any specialization
you may have for providing small, commercial insurance policies. Is there a minimum premium
per policy below which you do not wish to place insurance? Do you change a policy service fee
for small premium policies? If so, what is the fee and for what level of policy premiums is it
charged?
19. What special experience, knowledge or resources might make your firm superior to other firms
or how would your firm provide any unusual value to DCSD?
20. Based on your firm’s knowledge of Georgia law, do you feel that Sovereign
Immunity should be part of a defense under an insurance program at all levels of
claims? Why or Why Not?
21. Does your firm have the capability to assist the School District in an evaluation of its Risk
Management practices and operations?
Yes __________ No __________
If yes, please describe your firm's capabilities including how your firm has assisted other clients.
22. What type of educational classes or material do you provide to your clients that
can enhance their knowledge about insurance coverages, markets, or potential
claims?
23. References: Please list three current references of organizations of similar size to DCSD. Use
the form attached as Attachment “F”, Offeror’s Client Reference Form (page 53), and include
the approximate annual premium (if not confidential).
24. References: Please list three references of organizations of similar size to DCSD whose
business you lost in the last three years. Use the form attached as Attachment “F”, Offeror’s
Client Reference Form and include the approximate annual premium (if not confidential).
25. If your firm is selected and awarded a line of coverage or several lines of coverage
can you guarantee the County renewal pricing quotes at least 60 days in advance of the
effective date?
Yes __________ No __________
26. With that regard, please look at the chart contained in Attachment “D,” DeKalb County School
District Insurance Policy Listings with Premiums (pages 50-51).
For each policy with a current premium more than $50,000; state how much lead time your firm
would likely need to provide a quote at least 60 days in advance of the expiration. For the smaller
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 49
policies, state how much lead time would be needed for you to provide a quote at least 30 days in
advance of expiration.
27. Describe how you will protect confidentiality of any claim reports and related information
reported to your firm.
28. Describe how your firm designs, markets, and your philosophy of submitting the various lines
of coverage that we purchase.
Signed: ____________________________________________________________
Title: ____________________________________________________________
Date: ____________________________________________________________
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 50
ATTACHMENT C
RFP 22-490
Insurance Producer Services for
Property and Casualty Insurance
Information About DeKalb County School District’s Property Insurance
The following is submitted for informational purposes only to provide insight into DeKalb
County School District’s current property insurance coverage. Refer to Part I.B, General
Information (page 10) for the number of DCSD schools, centers, and stadiums.
The Property & Fine Arts premium covers DCSD property valued $3,639,377,671. DCSD's property
insurer for the period January 1, 2019, through January 1, 2021, was FM Global Insurance Company
(“FM Global”). Notice was received in the fall of 2020 that FM Global would be imposing substantial
premium increases, eliminating physical damage coverage for DCSD’s vehicles, and increasing
retention levels. Therefore, DCSD requested a comprehensive remarketing of its insurance program
for insurers that have traditionally served large public school district property portfolios like DCSD’s
portfolio.
As a result of remarketing by the current Broker for DCSD, at its December 7, 2020, meeting, the
DeKalb County Board of Education (“Board”) approved the purchase of a semi-annual policy from
Alliant Property Insurance Program (“APIP”) for the period of January 1, 2021, through July 1, 2021. A
semi-annual policy was purchased since the FM Global policy expired January 1, 2021, and since APIP
had a common expiration date for all its members of July 1, 2021.
On July 1, 2021, the Board renewed DCSD’s coverage with APIP for $1,873,662.52. The renewal
provided coverage for DCSD's Property, Equipment, Fine Arts, and Vehicles and Cyber Liability. The
APIP program will also cover the District’s vehicles for off road physical damage.
The APIP program also covered excess boiler coverage. This provides coverage for boiler explosion
and machinery breakdown. Cyber liability coverage was also covered. This cyber liability coverage
includes a $500,000 aggregate limit of liability for breach response. This limit will increase to
$1,000,000 if Beazley Nominated Services Providers are used. The breach response coverage
includes legal services, forensics, notification, credit monitoring and public relations/crisis management.
First party coverage is also included. This provides coverage for business interruption, cyber extortion,
data recovery, eCrime, cyrptojacking, reputation loss, criminal reward, computer hardware replacement
costs and invoice manipulation. A history of the insurance premiums paid by DCSD since 2018 for
property and fine arts is shown in Attachment D, DeKalb County School District Insurance Policy
Listings with Premiums (pages 50-51).
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 51
Attachment D
RFP 22-490
INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE
DeKalb County School District Insurance Policy Listings With Premiums
2018-19 2019-20 2020-21 2021-22
Policy
Premium Premium Premium Premium
Excess $224,843.00 $237,926.00 $235,276.00 $268,875.00
Workers’ (estimate)
Compensation
Directors & $228,043.00 $198,500.00 Non-Renewed N/A
Officers, EPLI,
ELL
Property & Fine $1,186,449.00 $1,360,178.00 $1,501,456.00 $1,873,633.00
Arts
Student $5,384.00 $5,384.00 Non-Renewed N/A
Athletic
Catastrophic
Student $76,922.00 Non-Renewed N/A N/A
Catastrophic
Government $27,000.00 $27,000.00 $29,099.00 $31,580.00
Crime
Student $6,855.00 $10,650.00 $10,505.00 $10,505.00
Blanket
Professional
Liability
$1,120.00 $1,120.00 $1,120.00 $1,350.00
Pipe Organ
Event Liability $12,728.64 $12,265.00 Not Purchased Not Purchased
for Graduation
Leased $1,574.56 $1,469.52 $1,016.98 $1,087.84
Warehouse
and Leased
Parking Lots
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 52
Superintendent $3,500.00 $3,500.00 $7,150.00 Paid through
Bond 7/1/2023
Leased $351.00 $1,110.00 $2,315.00 $2,439.00
Equipment
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 53
ATTACHMENT E
RFP 22-490
Insurance Producer Services for
Property and Casualty Insurance
Critical Paragraphs
Offerors must put their initials in the space provided in front of each critical paragraph and
sign below. Initials signify that the information has been read and the offeror agrees to comply
to the requirement, stipulations, terms and conditions. Attach and label “Critical Paragraph.”
1) ____ This RFP does not commit DCSD to any offeror to this RFP. DCSD is not liable for any costs
incurred by an offeror in responding to this RFP. There is no guarantee of any offeror receiving
an award or contract as a result of submitting a response to this RFP.
2) ____ Any news release or publicity pertaining to any phase of this RFP will be the responsibility of
DCSD and must be cleared through the DCSD’S Chief Communications and Community
Relations Officer.
3) ____ It is the responsibility of offerors to make themselves aware of and to comply with any addenda,
questions and answers posted to the DCSD website in relation to this RFP. All addenda must
be printed, signed by the certifying official and included in the RFP submittals. Failure to do so
will cause the offeror to be deemed non-responsive to the requirements of this RFP.
4) ____ Offerors to the RFP agree to fully indemnify DCSD as stated in the RFP, Part II, H, page 18.
5) ____ Offerors certify that they have not engaged in collusion and guarantee that their response is not
made in conjunction with or on behalf of another party and that they have not been directly or
indirectly induced or acted in any manner to result in restriction of trade or unfair advantage.
6) ____ The DCSD reserves the right to reject any and/or all responses submitted and to waive any
technicalities or minor irregularities in responses received. DCSD reserves the right to award
any resulting contract in the manner that is in the best interest of and most advantageous DCSD.
7) ____ Offeror understands that this solicitation requires Board of Education Approval.
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 54
ATTACHMENT F
RFP 22-490
Insurance Producer Services for
Property and Casualty Insurance
OFFEROR’S CLIENT REFERENCES
(Please copy this form and use one form per reference.)
Attach and label “Offeror’s Client References.”
_______________________________
Company Name Providing Reference
_______________________________
Address City/State/Zip
_______________________________
Name of Contact Person
_______________________________
Telephone Number of Contact Person
_______________________________
Email Address of Contact Person
_______________________________
Date/Duration of Service Relationship
Describe in Detail Services Provided (use additional sheets if necessary):
Time Period of Project or Contact _______________________________________________
Important! This is a vital part of your RFP submission. DCSD will verify client
references. It is advisable that you inform your reference contact person that you have
listed them for reference.
__________________________________________________________________________________________
__________________________________________________________________________________________
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 55
ATTACHMENT G
RFP 22-490
Insurance Producer Services for
Property and Casualty Insurance
Statement of Confidentiality and Non-Disclosure
Any non-public information made available to the offeror by DCSD in relation to this RFP shall be used
only for those purposes outlined in the RFP document and shall not be used in any other way without
the written permission of the DCSD.
If the offeror is uncertain about the proposed use of information provided in relation to this RFP, the
offeror shall consult with the DCSD RFP contact person as identified in the RFP document for
clarification.
The offeror agrees to assume full responsibility for protecting the confidentiality of DCSD records that
are not public information. Such information may include but is not limited to student and employee
data and other written and oral information of a personal and/or confidential nature, which shall be
safeguarded by the offeror to ensure that it is not improperly disclosed.
__________________________________
Offeror Company Name
__________________________________
Company Representative
__________________________________
Date
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 56
ATTACHMENT H
RFP 22-490
Insurance Producer Services for
Property and Casualty Insurance
SUSPENSION AND DEBARMENT CERTIFICATION
By submitting this RFP, the offeror certifies that the proposing company and/or its principals have not been
suspended, excluded, disqualified, debarred, proposed for debarment, declared ineligible or voluntarily excluded
from participation in any transaction by any federal or state department or agency and that the offeror complies
with all applicable orders, rules and regulations related thereto.
Further, by submitting this RFP, the offeror certifies that all lower tier participating individuals and/or company(s)
and all respective principals of lower tier participants have not been suspended, excluded, disqualified, debarred,
proposed for debarment, declared ineligible or voluntarily excluded from participation in any transaction by any
federal or state department or agency and that the offeror complies with all applicable orders, rules and
regulations related thereto.
The certification placed herein is a material representation of fact upon which reliance will be placed as RFP
submissions are evaluated and any transaction is entered into. If it is later determined that the prospective
offeror has knowingly rendered an erroneous certification, the DCSD may pursue all available remedies,
including but not limited to suspension and/or debarment.
The prospective offeror shall provide immediate written notice to the DCSD Purchasing Department if at any
time the prospective offeror learns that its certification was erroneous when submitted or has become erroneous
by reason of changed circumstances.
The prospective offeror agrees by submitting this form that, should the proposed transaction be entered into, the
prospective offeror shall not knowingly enter any lower tier transaction with a person or entity that is debarred,
suspended, declared ineligible, or voluntarily excluded from participation in this transaction.
By signing and submitting this form, the offeror is providing the certification set out above.
Signature of Engaging Official: _________________________________________ Date: _____________
(Offeror Company Name/Certifying Official Signature)
Further, the DCSD’s Purchasing Department will check the SAMS website at http://sams.gov to determine if
the offeror is listed.
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 57
ATTACHMENT I
RFP 22-490
Insurance Producer Services for
Property and Casualty Insurance
IMMIGRATION & SECURITY CERTIFICATION
If you are providing service, performing work, or delivering goods to the DeKalb County Board of
Education/DeKalb County School District including, but not limited to schools, warehouses and central
offices, the applicable Georgia Security and Immigration Compliance documents found here must be
completed, signed, notarized, and submitted with your bid/proposal. Failure to provide this document
with your bid/proposal will result in the disqualification of the bid/proposal.
1) Offeror/Bidder (the "Offeror") shall at all times comply with the Georgia Security and Immigration
Compliance Act, as amended, O.C.G.A. § 13-10-90 et. seq.
2) In order to ensure compliance with the Immigration Reform and Control Act of 1986 (IRCA), D.L. 99 -
603 and the Georgia Security and Immigration Compliance Act, as amended by the Illegal
Immigration Reform Act of 2011, O.C.G.A. § 13-10-90 et. seq. (collectively the “Act”), the Offeror
MUST INITIAL the statement applicable to Offeror below:
(a) _______ (Initial here): order to comply with the Act; is authorized to use and uses the federal
authorization program under the federal work authorization user identification number issued on
the date of authorization below; will continue to use the authorization program through out the
contract period; Offeror further warrants and agrees Offeror shall execute and return any and all
affidavits required by the Act and the rules and regulations issued by the Georgia Department of
Labor as set forth at Rule 300-10-1-.01 et. seq. [Offerors who initial (a) must attach and return a
signed, notarized Contractor Affidavit and Agreement with the Contract if awarded];
or
(b) _______ (Initial here): Offeror warrants that he/she does not employ any other persons, and
he/she does not intend to hire any employees or to perform the Contract. [Offerors who initial (b)
must attach and return a signed, notarized Affidavit of Exception with the Contract if awarded];
or
(c) ________ (Initial here): Offeror is an individual who is licensed pursuant to Title 26 or Title 43 or by
the State Bar of Georgia and is in good standing when such contract is for services to be rendered
by such individual and thus does not have to provide an affidavit.
3) _____ (Initial here) Offeror will not employ or contract with any subcontractor in connection with a
covered contract unless the subcontractor is registered, authorized to use, and uses the federal work
authorization program; and provides Offeror with all affidavits required by the Act and the rules and
regulations issued by the Georgia Department of Labor as set forth at Rule 300 -10-1-.01 et. seq.
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 58
4) _____ (Initial here) Offeror agrees that, if Offeror employs or contracts with any sub-contractor in
connection with the covered contract under the Act and DOL Rules 300-10-1- .01, et seq that Offeror will
secure from each sub -contractor at the time of the contract the sub-contractor’s name and address, the
employee-number applicable to the sub-contractor, the date the authorization to use the federal work
authorization program was granted to sub-contractor; the subcontractor’s attestation of the
subcontractor’s compliance with the Act and Georgia Department of Labor Rule 300-10-1-.01, et seq.;
and the subcontractor’s agreement not to contract with sub-subcontractors unless the sub-subcontractor
is registered, authorized to use, and uses the federal work authorization program; and provides
subcontractor with all affidavits required by the Act and the rules and regulations issued by the Georgia
Department of Labor as set forth at Rule 300-10-1-.01 et. seq.
5) ______ (Initial here) Offeror agrees to provide the DeKalb County School District with all affidavits of
compliance as required by O.C.G.A. § 13-10-90 et seq. and Georgia Department of Labor Rules 300-10-
1-.01, et seq within five (5) business days of receipt.
_____________________________ ______________________________
Signature Date
_____________________________ ______________________________
EEV/Basic Pilot Program Date of Authorization
User Identification Number
Firm Name: __________________________________________________________
Street/Mailing Address: ________________________________________________
City, State, Zip Code: __________________________________________________
Telephone Number: ___________________________________________________
Email Address: _______________________________________________________
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
______ DAY OF_____________________, 20____
___________________________________________________
Notary Public
My Commission Expires: ___________________________
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 59
DEKALB COUNTY SCHOOL DISTRICT
Offeror E-Verify Affidavit
By executing this affidavit, the undersigned Offeror verifies its compliance with Immigration Reform and
Control Act of 1986 (IRCA), Pub.L. 99-603, stating affirmatively that the individual firm or corporation which is
engaged in services on behalf of the DeKalb County School District has registered with, is authorized to use
and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement
program, in accordance with the applicable provisions and deadlines established by federal law and regulation.
Furthermore, the undersigned Offeror will continue to use the federal work authorization program throughout the
contract period. Offeror hereby attests that its federal work authorization user identification number and date of
authorization are as follows:
Federal Work Authorization User Identification
number:
Date of Authorization:
Name of Project:
Solicitation Number (if applicable):
Name of Public Employer: DeKalb County School District
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on _____, ____, 201__ in ___________________________________, __________
(city) (state)
Signature of Authorized Officer or Agent
Printed Name and Title of Authorized Agent:
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE _________ DAY OF _________, 201__.
Notary Public
My Commission Expires:
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 60
DEKALB COUNTY SCHOOL DISTRICT
Contractor Affidavit under O.C.G.A. § 13-10-91(b)(1)
By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. § 13-10-91, stating
affirmatively that the individual firm or corporation which is engaged in the physical performance of services on
behalf of the DeKalb County School District has registered with, is authorized to use and uses the federal work
authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance
with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned
contractor will continue to use the federal work authorization program throughout the contract period and the
undersigned contractor will contract for the physical performance of services in satisfaction of such contract only
with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-
91(b). Contractor hereby attests that its federal work authorization user identification number and date of
authorization are as follows:
Federal Work Authorization User Identification
number:
Date of Authorization:
Name of Subcontractor:
Name of Project:
Solicitation Number (if applicable):
Name of Public Employer: DeKalb County School District
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on _____, ____, 201__ in ___________________________________, __________
(city) (state)
Signature of Authorized Officer or Agent
Printed Name and Title of Authorized Agent:
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE _________ DAY OF _________, 201__.
Notary Public
My Commission Expires:
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 61
DEKALB COUNTY SCHOOL DISTRICT
Subcontractor Affidavit under O.C.G.A. § 13-10-91(b)(3)
By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. § 13-10-91, stating
affirmatively that the individual, firm or corporation which is engaged in the physical performance of services
under a contract with _________________________________________ on behalf of the DeKalb County
School District has registered with, is authorized to use and uses the federal work authorization program
commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable
provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned subcontractor will
continue to use the federal work authorization program throughout the contract period and the undersigned
subcontractor will contract for the physical performance of services in satisfaction of such contract only with sub-
subcontractors who present an affidavit to the subcontractor with the information required by O.C.G.A. § 13-10-
91(b). Additionally, the undersigned subcontractor will forward notice of the receipt of an affidavit from a sub-
subcontractor to the contractor within five (5) business days of receipt. Subcontractor hereby attests that its
federal work authorization user identification number and date of authorization are as follows:
Federal Work Authorization User Identification Number:
Date of Authorization:
Name of Subcontractor:
Name of Project:
Solicitation Number (if applicable):
Name of Public Employer: DeKalb County School District
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on _____, __________, 201___ in __________________________________, __________
(city) (state)
Signature of Authorized Officer or Agent
Printed Name and Title of Authorized Agent:
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE _________ DAY OF _________, 201__.
Notary Public
My Commission Expires:
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 62
DEKALB COUNTY SCHOOL DISTRICT
Sub-subcontractor Affidavit under O.C.G.A. § 13-10-91(b)(4)
By executing this affidavit, the undersigned sub-subcontractor verifies its compliance with O.C.G.A.§ 13-10-91,
stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of
services under a contract for _______________________________________ and
______________________________________ on behalf of the DeKalb County School District has
registered with, is authorized to use and uses the federal work authorization program commonly known as E-
Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines
established in O.C.G.A. § 13-10-91. Furthermore, the undersigned sub-subcontractor will continue to use the
federal work authorization program throughout the contract period and the undersigned sub-subcontractor will
contract for the physical performance of services in satisfaction of such contract only with sub-subcontractors
who present an affidavit to the sub-subcontractor with information required by O.C.G.A §13-10-91(b). The
undersigned sub-subcontractor shall submit, at the time of such contract, this affidavit to
___________________________________________________. Additionally, the undersigned sub-
subcontractor will forward notice of the receipt of any affidavit from a sub-subcontractor to the contractor within
five (5) business days of receipt. Sub-subcontractor hereby attests that its federal work authorization user
identification number and date of authorization are as follows:
Federal Work Authorization User Identification Number:
Date of Authorization:
Name of Sub-subcontractor:
Name of Project:
Solicitation Number (if applicable):
Name of Public Employer: DeKalb County School District
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on ____, __________, 201___ in ___________________________________, __________
(city) (state)
Signature of Authorized Officer or Agent
Printed Name and Title of Authorized Agent:
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE _________ DAY OF _________, 201__.
Notary Public
My Commission Expires:
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
ATTACHMENT J
SERVICE AGREEMENT
BETWEEN THE
DEKALB COUNTY SCHOOL DISTRICT
AND _______________________
Service Provider: ___________________
Project Name: ___________________
Address: ___________________
___________________
RFP No.: 22-490
Description: Insurance Producer Services for
Property and Casualty Insurance
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 64
THIS SERVICES AGREEMENT and the below referenced documents attached as Exhibits (hereinafter the
“Service Agreement") is made and entered into by and between the DeKalb County School District (hereinafter the “DCSD”)
whose address is 1701 Mountain Industrial Boulevard, Stone Mountain, Georgia 30083 and ________________________
(hereinafter the "Service Provider") whose physical address is ________________________. DCSD and Service Provider are
referred to herein collectively as the “Parties” and individually as a “Party.”
WHEREAS, DCSD desires to retain the services of a competent and qualified Service Provider to provide
_______________________________ services; and
WHEREAS, the DCSD has solicited for these services via an advertised request for proposals and has received
numerous responsive proposals thereto; and
WHEREAS, after review and consideration of all responsive proposals, DCSD intends to engage the Service
Provider to provide _______________________________ services; and
WHEREAS, the Service Provider remains agreeable to provide DCSD the _______________________________
services and represents that it is competent, qualified, capable, and prepared to do so according to the terms and conditions
stated herein;
The Service Agreement consist of:
a. This Service Agreement (Agreement for Services);
b. Request for Proposal (RFP) No. 22-490 (Exhibit A);
c. The Service Provider’s Proposal to the above-numbered RFP, including pricing, and any applicable Scope
of Services and any applicable Payment and Payment Terms Schedule attached except that objections or
amendments by Service Provider that have not been explicitly accepted by DCSD in writing in this Service
Agreement shall not be included in this Service Agreement and shall be given no weight or consideration;
(Exhibit B);
d. Board Directive Signed by the Superintendent and dated ___________ (Exhibit C); and
e. Notice of Award dated ___________ (Exhibit D).
This Service Agreement together with the aforementioned exhibits collectively forms the Service Agreement. All prior and
contemporaneous negotiations and Service Agreements between the Parties on the matters contained in this Service Agreement
are expressly merged into and superseded by this Service Agreement. DCSD shall not be bound by any additional terms and
conditions, including but not limited to, terms and conditions related to any provided service or good, limitations of the Service
Provider’s liability or any other third party's liability, limitation of warranties, packaging, invoices, service catalog, brochure,
technical data sheet, electronic disclosures, electronic Service Agreements, or other document which attempts to impose any
conditions at variance with or in addition to the terms and conditions of this Service Agreement.
Any inconsistency or conflict among the specific provisions of this Service Agreement shall be resolved as follows:
a. First, by giving preference to the specific provisions of this Service Agreement and any change orders or
modifications issued after execution of this Service Agreement;
b. Second, by giving preference to the specific provisions of the RFP attached hereto as Exhibit “A;”
c. Third, by giving preference to the specific provisions of Service Provider’s Proposal, including pricing
and any applicable Scope of Services and any applicable Payment and Payment Terms Schedule attached
hereto as Exhibit “B,” except that objections or amendments by Service Provider that have not been
explicitly accepted by DCSD in writing in this shall not be included in this Service Agreement and shall
be given no weight or consideration.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 65
NOW, THEREFORE, in consideration of the mutual promises, covenants and Service Agreements stated herein, and
for other good and valuable consideration, the sufficiency of which is hereby acknowledged by the Parties, DCSD and the
Service Provider agree as follows:
ARTICLE 1
PARTIES TO THE SERVICE AGREEMENT
The DCSD’s address and its contact person are:
DeKalb County School District
1701 Mountain Industrial Blvd.
Stone Mountain, GA 30083
Attention: _______________________________
Phone: ____________
Fax: ____________
Email: _______________________
With a copy to:
DeKalb County School District
1701 Mountain Industrial Boulevard
Stone Mountain, Georgia 30083
Attention: Mrs. Cheryl Watson-Harris, Superintendent
The Service Provider’s contact information is:
Company Name: _____________________
Address: _____________________
_____________________
Contact Person: _____________________
Title: _____________________
Phone No. Office: _________________________
Email: __________________________
Any notice or consent required to be given by or on behalf of any Party hereto to any other Party hereto shall be in
writing an shall be sent to DCSD or to the Service Provider by (a) registered or certified United States mail, return receipt
requested, postage prepaid, (b) personal delivery, or (c) overnight courier service. All notices sent to the above addresses shall
be binding unless said address is changed, and provided in writing to the other Party, no less than fourteen days before such
notice is sent.
ARTICLE 2
DURATION OF AGREEMENT
2.1 Agreement Term. The term of this Service Agreement begins on the date executed by the last Party to
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 66
execute below (hereinafter the “Effective Date”). The performance period for this Service Agreement is one (1) year
from the Effective Date.
2.2 Agreement Renewal. In addition to the base period of one (1) year, there are four (4) one-year optional
renewal terms (each a "Renewal Term") to be exercised at the sole discretion and approval of DCSD. Additionally, as
required by O.C.G.A. § 20-2-506, this Service Agreement shall terminate absolutely and without further obligation on the
part of DCSD at the close of the calendar year in which it was executed and at the close of each succeeding calendar year
for which it may be renewed, but shall be automatically renewed for each subsequent calendar year during the term unless
DCSD terminates this Service Agreement, by providing Service Provider with thirty (30) days advance notice of
termination prior to the end of the calendar year. Renewal will depend upon the best interests of the DCSD, funding, and
Service Provider’s performance subject to the other termination methods available to the DCSD herein.
2.3 Total Obligation. Pursuant to O.C.G.A § 20-2-506(b), DCSD’s total obligation under this Agreement is as
follows:
2019 $_______________________
ARTICLE 3
SCOPE OF SERVICES
3.1 DCSD does hereby retain Service Provider to furnish those services and to perform those tasks (collectively,
the “Services”) as further described in (i) the DCSD’s Request for Proposal ________, to include all attachments and addenda,
attached hereto as Exhibit “A” and incorporated herein by reference; and (ii) the Service Provider’s final responsive thereto,
attached hereto as Exhibit “B” and incorporated into this Agreement by this reference. A complete copy of the Scope of Work
section of RFP #_______, to include the Service Provider’s final responsive proposal, is attached as Exhibit “B” and made a
part of this Service Agreement.
3.2 Service Provider shall be solely responsible for the professional quality, accuracy, competence,
methodology, and the coordination of all Services performed pursuant to this Agreement.
3.3 DCSD’s review, approval, or acceptance of any of the Service Provider’s Services shall not be construed to:
(i) operate as a waiver of any rights the DCSD possesses under this Agreement; or (ii) waive or release any claim or cause of
action arising out of the Service Provider’s performance or nonperformance of this Agreement. The Service Provider shall
always remain liable to the DCSD in accordance with applicable law for any and all damages to the DCSD caused by the
Service Provider’s breach of this Agreement.
ARTICLE 4
COMPENSATION
4.1 The Service Provider agrees that the compensation for all services under this Service Agreement shall be
the specific price set forth in the attached Exhibit “A” and Exhibit “B.” There shall be no add-on charges of any kind.
ARTICLE 5
WORKING RELATIONSHIP
5.1 The Service Provider will function in cooperation with the DCSD’s designated representative, which is set
forth in Article 1 of this Service Agreement. The Service Provider will consult with the DCSD’s representative before finalizing
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 67
recommendations or taking action at Program milestones or other key decision points. The Service Provider shall fully
cooperate with the DCSD and, if applicable, the DCSD’s representative or designee. Such cooperation shall include, without
limitation, providing any requested information to the DCSD’s representative and advising, meeting with, consulting with, and
coordinating with the DCSD’s representative.
5.2 The DCSD shall have the right, at its sole discretion, to demand and require the Service Provider to remove
any employee or subcontractor working for the Service Provider on the Program and to replace the employee or subcontractor
without cost or liability to the DCSD.
5.3 For purposes of safety and otherwise, the Service Provider, at all times, shall ensure its ability to thoroughly
and clearly communicate, in any and all necessary languages, with the DCSD representative and with the Service Provider’s
employees, agents, representatives, and subcontractors. The Service Provider agrees to employ one or more supervisory-level
personnel capable of thoroughly and clearly communicating, in any and all necessary languages, with the DCSD’s
representative and with the Service Provider’s employees, agents, representatives, and subcontractors, and that such
supervisory-level and language-capable personnel shall be stationed at and assigned to the location(s) or site(s) where, and at
all times when, any and all work or services under this Service Agreement shall be performed.
5.4 The Service Provider shall ensure that any and all electronic devices, computers, software, hardware,
equipment and other similar and related items that are utilized by the Service Provider, or any entity or person under the Service
Provider’s supervision or control, do not harm, or allow harm, to the DCSD’s computers, systems, networks, and technology.
The Service Provider shall take any and all measures possible to protect the DCSD’s computers, systems, networks, and
technology from viruses and other malicious codes.
ARTICLE 6
INVOICING AND AGREEMENT PRICE
6.1 Invoices. The Service Provider shall submit invoices, to DCSD, for services rendered pursuant to the attached
Exhibit “A” and Exhibit “B.” Invoices will be paid by DCSD within thirty (30) days after receipt of the invoice from the
Service Provider. All invoices shall be submitted by Service Provider shall be submitted to: Ms. Carla Smith, Purchasing
Manager III, DeKalb County School District, 1701 Mountain Industrial Boulevard, Stone Mountain, Georgia, 30083.
6.2 Agreement Price. DCSD shall pay, and the Service Provider shall accept, as full and complete payment for
the Contractor's timely performance of its obligations hereunder the fixed price listed in Section 2.3. The price set forth in
Paragraph 2.3 shall constitute the Agreement Price, which shall not be modified except where evidence acceptable to DCSD
of changed market conditions and indices is produced. Any such proposed price escalation /de-escalation must be presented
in writing with substantiating proof to DCSD, for approval, a minimum of ninety (90) days prior to taking effect.
ARTICLE 7
CANCELLATION OR TERMINATION BY DCSD
7.1 DCSD reserves the right to cancel or terminate this Service Agreement at any time for any reason, with
notice in writing to the Service Provider. In the event of cancellation or termination, the DCSD shall pay to the Service Provider
all compensation earned for actual services rendered. Any cancellation or termination by DCSD shall be effective within thirty
(30) business days of the receipt of such cancellation or termination to Service Provider by DCSD.
7.2 Upon termination of this Service Agreement, the Service Provider shall:
7.2.1 Cease work under the Service Agreement and take all necessary or appropriate steps to limit
disbursements and minimize costs
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 68
7.2.2 Immediately cease using and return to the DCSD, any personal property or materials, whether
tangible or intangible, provided by the DCSD to the Service Provider
7.2.3 Cooperate in good faith with the DCSD and its employees, agents and contractors during the
transition period between the notification of termination and the substitution of any replacement
contractor(s); and
7.2.4 Immediately return to the DCSD any payments made by the DCSD for Services that were not
delivered or rendered by the Service Provider.
ARTICLE 8
INDEPENDENT CONTRACTOR
8.1 The Service Provider and its employees shall perform as an independent contractor and not an employee or
representative of the DCSD. The Service Provider retains sole and exclusive liability for all contributions, taxes or payments
required to be made on account of the Service Provider’s employees under federal or state income tax laws, unemployment and
workers’ compensation acts, social security acts, and all other legislation requiring employer contributions or withholdings.
8.2 The Service Provider shall maintain strict discipline among all personnel employed at
DCSD, nor shall any person employed on any Program site have in his or her possession any drugs, alcohol or firearms.
Unprofessional conduct, including but not limited to horseplay, wrestling, and fighting, shall not be permitted or allowed. No
employee, subcontractor or representative of the Service Provider shall use any tobacco product while at any Program site, on
any property owned by DCSD or at any function or event sponsored by or held on behalf of DCSD.
8.3 The Service Provider agrees that the Service Provider is not an employee of DCSD for purposes of the Patient
Protection and Affordable Care Act, 42 U.S.C. § 18001, et seq. (“ACA”), or for any other purpose. The Service Provider
agrees that the Service Provider will be responsible for reporting requirements under the ACA and certifies that the Service
Provider has their own individual health plan coverage. The Service Provider agrees that the Service Provider shall make the
necessary federal, state, and local filings and returns as required by law at the appropriate times, including, but not limited to,
federal, state, and local income tax (including estimates), filings and returns required by the Self-Employment Contribution
Act, and any other filing or return, required by federal, state, or local government. With respect to ACA compliance obligations,
Service Provider acknowledges and agrees that:
• Service Provider is responsible for filing Form 1094-C and Form 1095-C with respect to all
assigned workers assigned to DCSD;
• Service Provider is responsible for compliance with Internal Revenue Code Section 4980H
with respect to assigned workers;
• If requested by DCSD in connection with any governmental audit or inquiry, Service Provider
will cooperate in furnishing DCSD with detailed information on assigned workers as
reasonably needed for DCSD to respond to such audit or inquiry, and at no additional charge;
• Service Provider will offer health plan coverage to assigned workers (and their dependents)
that complies with the ACA's minimum value and affordability requirements and, during the
term of their staffing Service Agreement; and
• In addition to any existing indemnification obligations set forth in Article 20, herein, Service
Provider agrees to reimburse DCSD for any penalty or tax imposed against DCSD with respect
to any assigned worker, and to indemnify and hold harmless DCSD against all liabilities,
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 69
penalties and fees that may be imposed upon DCSD, under Internal Revenue Code Section
4980H(a) or (b); provided that DCSD will provide prompt notice to Service Provider of its
receipt of any notice of assessment of penalty or taxes under Code Section 4980H and Service
Provider will cooperate fully with DCSD in contesting such assessment and accepting
responsibility for its assigned workers.
ARTICLE 9
RESPONSIBILITY FOR SERVICES
9.1 In the performance of this Service Agreement, the Service Provider warrants that it shall consistently render
its best efforts and shall exercise that degree of skill and care which others would exercise in like circumstances and that its
Services will be performed without errors or omissions. Service Provider shall be responsible for the accuracy of its Services
and any error and/or omission made by the Service Provider in any work under this Service Agreement. Services performed
by the Service Provider shall be subject to review and acceptance in stages as required by the DCSD. Acceptance shall not
relieve the Service Provider of its professional obligation to correct, at Service Provider’s own expense, any errors in the S.
9.2 If Services performed by the Service Provider fail to meet the standards set forth in Paragraph 9.1, the DCSD
may elect to have the Service Provider re-perform, or cause to be re-performed, at no cost to the DCSD any of the Services
which fail to meet said standards where: (i) such failure appears during the performance of the Service Provider’s Services or
within one year from the date of completion of the Service Provider’s Services, and (ii) the DCSD notifies Service Provider of
any such failure within sixty (60) days of the time that the failure becomes apparent. This Paragraph 9.2 shall not be interpreted
to limit the right of the DCSD to pursue and obtain any and all other remedies against the Service Provider at law or in equity.
9.3 Service Provider warranties that any goods to be produced to or delivered to DCSD during the course and
scope of work for this Program will be of merchantable quality, free from defects in materials and workmanship.
9.4 DCSD acknowledges that the Service Provider shall be entitled to rely on the accuracy and currency of
information supplied by the DCSD or by any of the DCSD’s contractors or consultants, or available from generally accepted
reputable sources.
9.5 DCSD MAKES NO OTHER WARRANTIES, EXPRESS OR IMPLIED.
ARTICLE 10
OWNERSHIP OF WORK PRODUCT
10.1 Any reports, recommendations, estimates, specifications, drawings, technical data, sketches, computer
software, and all other information developed, created, procured or requested by the Service Provider in connection with its
performance under this Service Agreement (the “Information”) shall be the property of the DCSD. In entering into this Service
Agreement, the Service Provider hereby transfers to the DCSD all right, title, and interest, including the copyright, in and to the
Information.
10.2 Any reports, recommendations, estimates, specification, drawings, technical data, sketches, computer
software, and all other information developed by equipment vendors or other third parties that relate to the Program shall be
the property of the DCSD. This provision shall not act to transfer rights of DCSDs of standard software or specification
packages for which copyright is retained by the developer.
10.3 All original technical data, evaluations, reports and other work product of the Service Provider shall be
delivered to the DCSD upon the completion, cancellation or termination of Services under this Service Agreement within three
(3) business days of such completion, cancellation or termination. The Service Provider may retain one (1) copy of all
documents produced by the Contractor for its permanent file.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 70
ARTICLE 11
ACCOUNTING AND RECORDS
11.1 The Service Provider shall maintain a system of accounting and record keeping for all Services. Further, the
Service Provider will allow the DCSD’s inspection of necessary supporting receipts and documentation for audit purposes for
a period of six (6) years after completion of Services provided under this Service Agreement.
ARTICLE 12
COMPLIANCE WITH LAWS
12.1 The Service Provider shall comply with all federal, state and local laws, regulations, ordinances, and DeKalb
County Board of Education policies that are in any way applicable to the performance of its Services under this Service
Agreement including but not limited to laws governing health, safety, the protection or preservation of the environment, and
occupational licensing.
ARTICLE 13
EQUAL EMPLOYMENT OPPORTUNITY
13.1 The Service Provider will not discriminate against any worker, employee or applicant for employment
because of race, color, religion, sex, national origin, age, citizenship status, veteran status, sexual orientation or handicap. The
Service Provider will take affirmative action to ensure that applicants are employed, and that workers are treated during
employment, without regard to their race, color, religion, sex, national origin, age, citizenship status, veteran status, sexual
orientation or handicap. Such action shall include, but not be limited to the following: employment, upgrading, demotion, or
transfer, recruitment, or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and
selection for training, including apprenticeship.
ARTICLE 14
CONTINGENCY FEES
14.1 The Service Provider represents that it has not employed and shall not employ any person other than its own
principals and employees to solicit this Service Agreement or any contract with the DCSD, and that it has not and shall not pay
any person other than its own principals and employees any fee, commission, percentage, gift or other consideration contingent
upon or resulting from the award or making of this Service Agreement or any other contract with the DCSD
ARTICLE 15
SUBCONTRACTORS
15.1 Service Provider shall manage all work and Services performed under this Service Agreement. Upon the
DCSD’s prior written consent, the Service Provider may subcontract all or part of the Services to be provided. In such event,
the rights and obligations of the Service Provider and the DCSD will not be diminished.
15.2 All of the Service Provider’s Subcontractors shall be directly responsible to Service Provider and shall be
under the Service Provider’s direct supervision. The Service Provider shall be as fully responsible and accountable to the DCSD
for the acts and omissions of its Subcontractors and of persons either directly or indirectly employed by Subcontractors in the
performance of Services under this Service Agreement as the Service Provider is for the acts and omissions of persons it directly
employs. Other than the DCSD being a third-party beneficiary to any Service Agreement between the Service Provider and its
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 71
Subcontractors, no other contractual relationship between DCSD and any subcontractor is created by any provision contained
in this Service Agreement.
15.3 If the Service Provider utilizes Subcontractor(s) with respect to this Service Agreement then the Service
Provider will require Subcontractor(s) to comply with all terms and conditions of this Service Agreement including, but not
limited to the insurance requirements. The Contractor shall require all Subcontractors to supply a certificate of insurance as
required herein before the Subcontractor commences any work.
ARTICLE 16
SUCCESSORS AND ASSIGNS
16.1 The Service Provider shall not assign its rights hereunder, excepting its right to payment, nor shall it delegate
any of its duties hereunder without the written consent of the DCSD. Subject to the provisions of the immediately preceding
sentence, each Party hereto binds itself, its successors, assigns and legal representatives to the other and to the successors,
assigns and legal representatives of such other Party.
ARTICLE 17
INSURANCE
17.1 The Service Provider and all Subcontractors shall maintain insurance in the types and coverage amounts
shown below, which insurance shall provide coverage for Service Provider during the term of this Service Agreement. Prior
to the date the Service Provider signs this Service Agreement, the Service Provider shall provide the DCSD with (i) an
endorsement from the insurer naming the DeKalb County School District and The DeKalb County Board of Education as an
additional insured under the liability policies and (ii) certificate(s) verifying that these insurance coverages and limits are in
force. Additional certificates of insurance shall be provided whenever individual policies are renewed (or replaced) on their
anniversary date and at such other times as the DCSD requests.
17.2 If the Service Provider is a joint venture involving two (2) or more entities, then each independent entity
shall satisfy the limits and coverages specified below or the joint venture will be a named insured under each respective policy
specified.
17.3 The insurance requirements of this Service Agreement are:
Type of Insurance Coverage Limits
Workers Compensation $1,000,000
Employer’s Liability $1,000,000 annual aggregate
Comprehensive General Liability $2,000,000 annual aggregate
Including Contractual Liability, $1,000,000 per occurrence
Bodily Injury and Property Damage
Comprehensive Auto Liability $3,000,000 per accident
Bodily Injury and Property Damage
Covering Owned, Hired and Non-Owned Autos
Professional Liability
Umbrella or Excess Insurance $5,000,000 annual aggregate
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 72
17.4 The Service Provider waives all rights, including rights of subrogation, against the DCSD and its respective
directors, officers, partners, Board Members, officials, agents, insurers, subcontractors, consultants and employees for damages
covered by any type of insurance during and after the completion of the Work.
17.5 Certificates of Insurance must be executed with the following provisions:
(a) Certificates to contain policy number, policy limits, and policy expiration date of all policies issued in
accordance with this Service Agreement;
(b) Certificates to contain the project number, location of property, name of property and operations
information to which the insurance applies;
(c) Certificates are to be issued to:
DeKalb County School District
DeKalb County Board of Education
1701 Mountain Industrial Blvd.
Stone Mountain, GA 30083
Attention: Risk Management Department
(d) Certificates shall state that the policy or policies shall not expire, be cancelled or altered without at least
sixty (60) days prior written notice to the DCSD.
(e) Service Provider shall be responsible and have the financial wherewithal to cover any deductibles or
retentions included on the certificate of insurance.
ARTICLE 18
ILLEGAL IMMIGRATION REFORM AND ENFORCEMENT ACT OF 2011
18.1 The Illegal Immigration Reform and Enforcement Act of 2011 applies to and is a requirement for all DCSD
Contracts for physical performance of services (i.e. public works contracts).
18.2 Service Provider’s compliance is set forth in Exhibit “B”. The Service Provider warrants and represents that
evidence of the Service Provider and their subcontractor(s)’ compliance by completing the following forms is included in
Exhibit “B” and incorporated herein as reference:
(a) Immigration and Security Certification
(b) Contractor Affidavit
(c) Subcontractor Affidavit
(d) Sub-Subcontractor Affidavit
ARTICLE 19
TERMINATION FOR CAUSE
19.1 Either Party hereto may terminate this Service Agreement upon giving seven (7) days prior written notice to
the other Party in the event that such other Party substantially fails to perform its material obligations set forth herein. Any
Party seeking to terminate this Service Agreement for cause shall, as a condition precedent to the termination of this Service
Agreement, provide the other Party written notice specifically describing its failure to perform its material obligations and
allow that Party thirty (30) days after receipt of the notice in which to cure any performance deficiency.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 73
ARTICLE 20
INDEMNIFICATION
20.1 The Service Provider agrees to hold harmless and indemnify the DCSD, its Board, officers, employees and
representatives (herein “Released Parties”) from and against any and all liability, claims, actions, causes of action, losses,
damages, demands, suits, judgments, costs and expenses arising out of bodily injury (including death) to persons, damage to
property, or financial loss, including, but not limited to, any and all costs, expenses, legal fees and liabilities, incurred in and
about investigation, defense or prosecution thereof, to the extent caused in whole or in part by a negligent act, error or omission
of the Service Provider or any subcontractor(s), or as a result of defective Services under this Service Agreement.
20.2 The Service Provider further agrees to release, indemnify, defend and hold harmless the Released Parties
from any and all claims, demands, rights, liabilities and causes of action inuring to the Service Provider from events over which
the Released Parties exercise no control. The Service Provider further agrees to indemnify, defend and hold harmless the
Released Parties from any and all claims, demands, rights, liabilities and causes of action arising out of DCSD’s performance
under this Service Agreement.
ARTICLE 21
AGREEMENT ADMINISTRATION
21.1 DCSD and the Service Provider have each appointed certain individuals whose names and phone numbers
appear in Article 1 to be their respective representatives in the administration and performance of this Service Agreement. The
DCSD’s representative shall have no power or authority to change this Service Agreement, or to execute or agree to any change
orders. The DCSD may change its representative or declare a designee by written notice to the Service Provider.
21.2 To be binding against the DCSD, and as a condition precedent thereto, any addition, deletion or modification
to the terms of this Service Agreement must be in writing and signed by the DCSD. The Service Provider acknowledges that
the DCSD does not, and will not be deemed to, waive this condition precedent under any circumstances.
21.3 Failure of the DCSD or the Service Provider to insist in any one or more instances on performance of any of
the terms and conditions of this Service Agreement, or to exercise any right or privilege contained in this Service Agreement
or the waiver of any breach of the terms and conditions of this Service Agreement, shall not be considered as creating or
constituting a waiver of any such terms, conditions, rights or privileges, and the same shall continue and remain in force and
effect.
21.4 The Service Provider and the DCSD will adhere to all applicable health and safety laws, rules and regulations
including Occupational Safety and Health Administration’s (“OSHA”) Rules and Regulations effective at the time the work
was performed.
21.5 This Service Agreement shall be governed by the laws of the State of Georgia.
ARTICLE 22
PUBLIC RECORDS
22.1 The laws of the State of Georgia, including the Georgia Open Records Act, as provided in O.C.G.A. Section
50-18-70 et seq., require procurement records and other records to be made public unless otherwise provided by law.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 74
ARTICLE 23
FORCE MAJEURE
23.1 The Service Provider will not be responsible or liable in any way for delay or failure to perform its obligations
under this Service Agreement during any period which performance is prevented or hindered by conditions reasonably beyond
its control, acts of God, fire, flood, and other unusually adverse weather conditions, war, embargo, explosions, riots, laws, rules,
regulations and order of any governmental authority.
ARTICLE 24
CAPTIONS
24.1 The headings in this Service Agreement are for the convenience of the Parties hereto and shall in no way
affect the construction or interpretation of this Service Agreement or any part hereof.
ARTICLE 25
ENTIRE SERVICE AGREEMENT
25.1 This Service Agreement constitutes the entire and exclusive Service Agreement between the Parties with
reference to the Services and supersedes any and all prior communications, discussions, negotiations, understandings, or
Service Agreements. This Service Agreement may be amended only by a writing signed by both the DCSD and the Service
Provider. The signature of Service Provider below, represents to DCSD that he/she is duly authorized to execute and deliver
this Service Agreement on behalf of Service Provider.
ARTICLE 26
MISCELLANEOUS
26.1 Unless otherwise expressly provided to the contrary in this Service Agreement, the term “day” shall mean
calendar day.
26.2 Any claim, dispute or other matter in question arising out of or related to this Service Agreement shall be
subject to mediation as a condition precedent to the institution of legal or equitable proceedings by either party. If such matter
relates to or is the subject of a lien arising out of the Service Provider’s services, the Service Provider may proceed in accordance
with applicable law to comply with the lien notice or filing deadlines prior to resolution of the matter by mediation. The DCSD
and Service Provider shall endeavor to resolve claims, disputes and other matters in question between them by mediation which,
unless the parties mutually agree otherwise, shall be in accordance with the Mediation Rules of the American Arbitration
Association currently in effect. Request for mediation shall be filed in writing with the other Party to this Service Agreement
and with the American Arbitration Association. The request may be made concurrently with the filing of a civil action but, in
such event, mediation shall proceed in advance of legal or equitable proceedings, which may be stayed pending mediation for
a period of 60 days from the date of filing, unless stayed for a longer period by Service Agreement of the parties or a court
order. The Parties shall share the mediator’s fee and any filing fees equally. The mediation shall be held in the place where
the Program is located, unless another location is mutually agreed upon. Subject to the express approval of the DeKalb County
Board of Education, agreements reached in mediation shall be enforceable as settlement agreements in any court having
jurisdiction thereof.
26.3 The exclusive venue for any civil action arising out of or related to this Service Agreement shall be in the
federal, superior, or state courts of DeKalb County, Georgia. If any civil action is instituted to interpret, enforce or rescind this
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 75
Service Agreement, the prevailing party in such lawsuit shall be entitled to recover, in addition to any other relief awarded, its
reasonable attorney fees and other fees, costs, and expenses of every kind, incurred in connection with the lawsuit.
26.4 If any provision of this Service Agreement or the application thereof to any person or circumstance shall to
any extent be held invalid, then the remainder of this Service Agreement or the application of such provision to persons or
circumstances, other than those as to which it is held invalid, shall not be affected thereby, and each provision of this Service
Agreement shall be valid and enforced to the fullest extent permitted by law.
26.5 This Service Agreement may be executed in several counterparts, each of which shall be deemed an original,
and all such counterparts together shall constitute one and the same Service Agreement. A scanned or photocopy of an original
signature shall be deemed an original for purposes of this Service Agreement.
26.6 Service Provider, and all personnel of Service Provider, agree to a background check. The Service Provider, and
all personnel of Contractor, shall undergo the same criminal background check, within the last 365 days, as required by DCSD
employees. Such background checks will be performed by DCSD at the expense of the Service Provider. Additionally, any
charges against the Service Provider, or personnel, may be deemed unacceptable in DCSD’s sole discretion regardless of
whether dismissed, expunged, sealed, removed from the record, treated as a “first offender” or dead docketed. Upon receipt
and evaluation of DCSD’s background check results, DCSD may demand that the personnel named in the check result, not
provide services to DCSD premises. Any failure of the Service Provider, or personnel, to obtain a criminal records background
check through DCSD, as stated herein, may result in termination of any resulting contract between Service Provider and DCSD.
Confirmation of background checks must be submitted in writing prior to commencement of any services to DCSD to: Ms.
Carla Smith, Purchasing Manager III, DeKalb County School District, 1701 Mountain Industrial Boulevard, Stone Mountain,
Georgia, 30083.
26.7 Service Provider shall obtain prior written approval from DCSD’s Department of Communications before the
distribution of any news, press release or any marketing materials, by Service Provider, which mentions DCSD, DeKalb County
Board of Education, or any of the schools or centers within DCSD, or uses DCSD’s logo or trademark. All requests for prior
written approval shall be sent to: Communications Department, DeKalb County School District, 1701 Mountain Industrial
Blvd., Stone Mountain, Georgia, 30083.
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 76
IN WITNESS WHEREOF, the DCSD and the Service Provider, agreeing to the above terms and conditions and
intending to be legally bound and each acting through persons duly authorized, have placed their signatures on
duplicate original copies of this Service Agreement.
DCSD: SERVICE PROVIDER:
DEKALB COUNTY SCHOOL DISTRICT _________________________
By: By:
[Signature] [Signature] [SEAL]
Mrs. Cheryl Watson-Harris, Superintendent Print Name:______________________________
Title:_______________________________
1701 Mountain Industrial Blvd __________________
Stone Mountain, GA 30083 __________________
Address
__________________________________ __________________________________
[Date of Execution] [Date of Execution]
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 77
EXHIBIT “A”
DeKalb County School District RFP No. ___________
For
__________________________ Services
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 78
EXHIBIT “B”
Service Provider’s Proposal including pricing
and any applicable Scope of Services
and any applicable Payment and Payment Terms Schedule
attached except that objections or amendments by the
Service Provider that have not been explicitly accepted by DCSD in Writing In this Service
Agreement and Contract shall not be included in the Contract Documents Or this
Service Agreement and shall be given no weight or consideration
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 79
EXHIBIT “C”
DeKalb County Board of Education Directive
Signed by the Superintendent and dated ________________________
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 80
EXHIBIT “D”
Notice of Award Letter Dated ______________________
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 81
END OF EXHIBITS
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 82
ATTACHMENT K
RFP 22-490
INSURANCE PRODUCER SERVICES FOR
PROPERTY AND CASUALTY INSURANCE
SIGNATURE PAGE
I certify that I have read this RFP document in its entirety and agree to conform to and comply with the
terms, conditions and requirements of this RFP. I also certify that I am a duly appointed official of the
offering company with the authority to authorize and engage this RFP submittal. Further, I certify that
the contents of the response to this RFP are true, accurate and complete.
______________________________ _______________________________
Printed Name/Engaging Authorized Position/Title
Company Official
_______________________________
Offeror’s Company Name
_______________________________ ________________________________
Signature/Engaging Authorized E-mail address
Company Official
________________________________
Telephone Number
______________________________
Date
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 22-490 INSURANCE PRODUCER SERVICES FOR PROPERTY AND CASUALTY INSURANCE PAGE 83
END OF RFP
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE