HomeMy WebLinkAboutC2022-124 - 6/28/2022 - Approved DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
o _ SERVICE AGREEMENT NO. 4119
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Workers' Compensation Third-Party Administrator Services
THIS 'Workers' Compensation Third-Party Administrator Services Agreement
("Agreement") is entered into by and between the City of Corpus Christi, a Texas home-
rule municipal corporation ("City") and TRISTAR Claims Management Services, Inc.
("Contractor"), effective upon execution by the City Manager or the City Manager's
designee ("City Manager").
WHEREAS, Contractor has bid to provide Workers' Compensation Third-Party
Administrator Services in response to Request for Bid/Proposal No. 4119 ("RFB/RFP"),
which RFB/RFP includes the required scope of work and all specifications and which
RFB/RFP and the Contractor's bid or proposal response, as applicable, are
incorporated by reference in this Agreement as Exhibits 1 and 2, respectively, as if each
were fully set out here in its entirety.
NOW, THEREFORE, City and Contractor agree as follows:
1, Scope, Contractor will provide Workers' Compensation Third-Party Administrator
Services ("Services") in accordance with the attached Scope of Work, as shown
in Attachment A, the content of which is incorporated by reference into this
Agreement as if fully set out here in its entirety, and in accordance with Exhibit 2.
2. Term.
(A) The Term of this Agreement is one year beginning on the date provided in
the Notice to Proceed from the Contract Administrator or the City's Procurement
Division. The parties may mutually extend the term of this Agreement for up to
four additional one-year periods ("Option Periods)"), provided, the parties do so
in writing prior to the expiration of the original term or the then-current Option
Period.
(B) At the end of the Term of this Agreement or the final Option Period, the
Agreement may, at the request of the City prior to expiration of the Term or final
Option Period, continue on a month-to-month basis for up to six months with
compensation set based on the amount listed in Attachment B for the Term or the
final Option Period. The Contractor may opt out of this continuing term by
providing notice to the City at least 30 days prior to the expiration of the Term or
final Option Period. Enuring the month-to-month term, either Party may terminate
the Agreement upon 30 days' written notice to the other Party.
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DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
3. Compensation and Payment. This Agreement is for an amount not to exceed
$172,077.00, subject to approved extensions and changes. Payment will be made
for Services performed and accepted by the City within 30 days of acceptance,
subject to receipt of an acceptable invoice. All pricing must be in accordance
with the attached Bid/Pricing Schedule, as shown in Attachment B, the content
of which is incorporated by reference info this Agreement as if fully set out here in
its entirety. Any amount not expended during the initial term or any option period
may, at the City's discretion, be allocated for use in the next Option Period.
Invoices must be mailed to the following address with a copy provided to the
Contract Administrator:
City of Corpus Christi
Attn: Accounts Payable
P.O. Box 9277
Corpus Christi, Texas 78469-9277
4. Contract Administrator. The Contract Administrator designated by the City is
responsible for approval of all phases of performance and operations under this
Agreement, including deductions for non-performance and authorizations for
payment. The City's Contract Administrator for this Agreement is as follows:
Name: Gilbert Sanchez
Department: Legal Department
Phone: (361 ) 826-3739
Email: GilbertS2@cctexas.com
5. Insurance; Bonds.
(A) Before performance can begin under this Agreement, the Contractor must
deliver a certificate of insurance ("COI'"), as proof of the required insurance
coverages, to the City's Risk Manager and the Contract Administrator.
Additionally, the COI must state that the City will be given at least 30 days'
advance written notice of cancellation, material change in coverage, or intent
not to renew any of the policies. The City must be named as an additional insured.
The City Attorney must be given copies of all insurance policies within 10 days of
the City Manager's written request. Insurance requirements are as stated in
Attachment C, the content of which is incorporated by reference into this
Agreement as if fully set out here in its entirety.
(B) In the event that a payment bond, a performance bond, or both, are
required of the Contractor to be provided to the City under this Agreement before
performance can commence, the terms, conditions, and amounts required in the
bonds and appropriate surety information are as included in the RFB/RFP or as
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may be added to Attachment C, and such content is incorporated here in this
Agreement by reference as if each bond's terms, conditions, and amounts were
fully set out here in its entirety.
6. Purchase Release Order. For multiple-release purchases of Services to be
provided by the Contractor over a period of time, the City will exercise its right to
specify time, place and quantity of Services to be delivered in the following
manner: any City department or division may send to Contractor a purchase
release order signed by an authorized agent of the department or division. The
purchase release order must refer to this Agreement, and Services will not be
rendered until the Contractor receives the signed purchase release order.
7. Inspection and Acceptance. City may inspect all Services and products supplied
before acceptance. Any Services or products that are provided but not
accepted by the City must be corrected or re-worked immediately at no charge
to the City. If immediate correction or re-working at no charge cannot be made
by the Contractor, a replacement service may be procured by the City on the
open market and any costs incurred, including additional costs over the item's
bid/proposal price, must be paid by the Contractor within 30 days of receipt of
City's invoice.
8. Warranty.
(A) The Contractor warrants that all products supplied under this Agreement
are new, qualify items that are free from defects, fit for their intended purpose,
and of good material and workmanship. The Contractor warrants that if has clear
title to the products and that the products are free of liens or encumbrances.
(B) In addition, the products purchased under this Agreement shall be
warranted by the Contractor or, if indicated in Attachment D by the
manufacturer, for the period stated in Attachment D. Attachment D is attached
to this Agreement and is incorporated by reference into this Agreement as if fully
set out here in its entirety.
(C) Contractor warrants that all Services will be performed in accordance
with the standard of care used by similarly situated contractors performing similar
services.
9. Quality/Quantity Adjustments. Any Service quantities indicated on the Bid/Pricing
Schedule are estimates only and do not obligate the City to order or accept more
than the City's actual requirements nor do the estimates restrict the City from
ordering less than its actual needs during the term of the Agreement and including
any Option Period, Substitutions and deviations from the City's product
requirements or specifications are prohibited without the prior written approval of
f he Contract Administrator.
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10. bion-Appropriation. The continuation of this Agreement after the close of any
fiscal year of the City, which fiscal year ends on September 30th annually, is subject
to appropriations and budget approval specifically covering this Agreement as
an expenditure in said budget, and if is within the sole discretion of the City's City
Council to determine whether or not to fund this Agreement. The City does not
represent that this budget item will be adopted, as said determination is within the
City Council's sole discretion when adopting each budget.
11. Independent Contractor. Contractor will perform the work required by this
Agreement as an independent contractor and will furnish such Services in its own
manner and method, and under no circumstances or conditions will any agent,
servant or employee of the Contractor be considered an employee of the City.
12. Subcontractors. In performing the Services, the Contractor may use
subcontractors in connection with the work performed under this Agreement.
When using subcontractors, however, the Contractor must obtain prior written
approval from the Contract Administrator unless the subcontractors were named
in the bid or proposal or in an Attachment to this Agreement, as applicable. In
using subcontractors, the Contractor is responsible for all their acts and omissions
to the same extent as if the subcontractor and its employees were employees of
the Contractor. All requirements set forth as part of this Agreement, including the
necessity of providing a COI in advance to the City, are applicable to all
subcontractors and their employees to the same extent as if the Contractor and
its employees had performed the work. The City may, at the City's sole discretion,
choose not to accept Services performed by a subcontractor that was not
approved in accordance with this paragraph.
13. Amendments. This Agreement may be amended or modified only in writing
executed by authorized representatives of both parties.
14. Waiver. No waiver by either party of any breach of any term or condition of this
Agreement waives any subsequent breach of the same.
15. Taxes, The Contractor covenants to pay payroll faxes, Medicare faxes, FICA
taxes, unemployment taxes and all other applicable taxes. Upon request, the City
Manager shall be provided proof of payment of these taxes within 15 days of such
request.
16. Notice. Any notice required under this Agreement must be given by fax, hand
delivery, or certified mail, postage prepaid, and is deemed received on the day
taxed or hand-delivered or on the third day after postmark if sent by certified mail.
Notice must be sent as follows:
IF TO CITY:
City of Corpus Christi
Attn: Gilbert Sanchez
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(B) Alternatively, the City may terminate this Agreement for convenience upon
30 days advance written notice to the Contractor. The City may also terminate
this Agreement upon 24 hours written notice to the Contractor for failure to pay or
provide proof of payment of taxes as set out in this Agreement.
19. Owner's Manual and Preventative Maintenance. Contractor agrees to provide a
copy of the owner's manual and/or preventative maintenance guidelines or
instructions if available for any equipment purchased by the City pursuant to this
Agreement. Contractor must provide such documentation upon delivery of such
equipment and prior to receipt of the final payment by the City.
20. Limitation of Liability. The City's maximum liability under this Agreement is limited
to the total amount of compensation listed in Section 3 of this Agreement. In no
event shall the City be liable for incidental, consequential or special damages.
21. Assignment. No assignment of this Agreement by the Contractor, or of any right
or interest contained herein, is effective unless the City Manager first gives written
consent to such assignment. The performance of this Agreement by the
Contractor is of the essence of this Agreement, and the City Manager's right to
withhold consent to such assignment is within the sole discretion of the City
Manager on any ground whatsoever.
22. Severability. Each provision of this Agreement is considered to be severable and,
if, for any reason, any provision or part of this Agreement is determined to be
invalid and contrary to applicable law, such invalidity shall not impair the
operation of nor affect those portions of this Agreement that are valid, but this
Agreement shall be construed and enforced in all respects as if the invalid or
unenforceable provision or part had been omitted.
23. Order of Precedence. In the event of any conflicts or inconsistencies between this
Agreement, its attachments, and exhibits, such conflicts and inconsistencies will
be resolved by reference to the documents in the following order of priority:
A. this Agreement (excluding attachments and exhibits);
B. its attachments;
C. the bid solicitation document including any addenda (Exhibit 1 ); then,
D. the Contractor's bid response (Exhibit 2).
24. Certificate of Interested Parties. Contractor agrees to comply with Texas
Government Code Section 2252.908, as it may be amended, and to complete
Form 1295 "Certificate of Interested Parties" as part of f his Agreement if required
by said statute.
25. Governing Low. Contractor agrees to comply with all federal, Texas, and City laws
in the performance of this Agreement. The applicable law for any legal disputes
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arising out of this Agreement is the law of the State of Texas, and such form and
venue for such disputes is the appropriate district, county, or justice court in and
for Nueces County, Texas.
26. Public Information Act Requirements. This paragraph applies only to agreements
that have a stated expenditure of at least $1 ,000,000 or that result in the
expenditure of at least $1 ,000,000 by the City. The requirements of Subchapter J,
Chapter 552, Government Code, may apply to this contract and the Contractor
agrees that the contract can be terminated if the Contractor knowingly or
intentionally fails to comply with a requirement of that subchapter.
27. Entire Agreement. This Agreement constitutes the entire agreement between the
parties concerning the subject matter of this Agreement and supersedes all prior
negotiations, arrangements, agreements and understandings, either oral or
written, between the parties.
SIGNATURES ON NEXT PAGE
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DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
CONTRACTOR
Signature:-
Printed Name: X
4, 11414-1—1 �1
Title:
Date: rb
CITY OF CORPUS CHRISTI
DocuSigned by'.
M2022-102 Authorized By
JosH'CM0n%y
Assistant Director of Finance - Procurement Council 6-28-2022
Date- Ds
DS
Approved as to form:
5 DocuSigned by: ATTEST:
�1`04 RWA, 6/24/2022 DOCUS"Igned by:
5fil jf4 B
IJ -
)�—S-S-1 n y Attorney Date
Rebecca Huerta
City Secretary
Attached and Incorporated by Reference:
Attachment A: Scope of Work
Attachment B: Bid/Pricing Schedule
Attachment C: Insurance and Bond Requirements
Attachment D: Warranty Requirements
Incorporated by Reference Only:
Exhibit 1 : RFB/RFP No. 4119
Exhibit 2: Contractor's Bid/Proposal Response
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DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
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Attachment A - Seeps of Work
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1.1 Gene all irements
A. The City of Corpus C hrisfi is seeking qualified Conl r-r ctor/rhird-I'c:Wy
A dminisfralor (TPS) to provide services to Ihe Risk dvtcancQ gerner..rf C:uuvrwyion for
Workers' C::;:ornpcans(:ation Prograrn,
B. The C:i`ify of' �..,oq.,)us is c:a horrvreea-ruler city which operates under the Council
hc;arrc.sger form of g(.-.)ve,rrrr-ner-at. They City provides a full range of rno�I.rlcif:ac
serviceas
1 ares(..A eacby statute or charfor. ' heseservices ir ;U epolice, fire
and orer rnc�y raedical serv4Mes parksan rocrorfi rrl fac; 6ties, library
services, street 6ntenance
�
arra COrastrUCfiorr, pu fic:: improver eats, water
and waste a-for uNitleas, solid vvasfe and landfill, ra,aariraa, airport operations
and gas utilities services and systerns.
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C.The Contractor is to provu a a broad representation of medical providers I
uraclu e d in any workers' corrlpe;n afion he;a4fh care network ra-aacde avoilla6':ale to
it L)y ihe C oniractor, inc.:lc. ding,but not llrraite d to vetted treating physicJans,
clinics, specialists, physical therapists, re I"°acabiktation services, and phcarr'nacoieas.
The Contractor is to provide ca plan allowing ca reduction in fees in tf-)e event of
failure to satisfy an agreed-upon d-upon performanc:ea star'idarrd, corasistir`'g of l
sfan and industry >e rformc:ances criteria and any special se-arvic:e> criteria
otherwise cacgreed upon,
D.C:oratrac:for must provide the services Fisted below,
I , barky intervention programs (medic(.-al! cases management)
rat)
f.ttili ation revie w/faro- authori ation services
, Medical bill aucdifs
. Availability and use, ofworkers' compensation health cc,)r,e 1504 ne.lwork;
networks or aad6` & medical fere discount c:arron errne:rats, f
Rehabilitation services �
`yocatlonol case rraanager'nent services
1. Assistance with developrrerrf of rnedicaG provider networks �
, On-lime computer services
. tte riding D C;M heorings (they adjuster is expe:cfecf Io aftend ali hea6ngs) l
10, Irnp airy-hent rcafings/reaview
11 . un-off (per-claim basis)
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
12. Ru i inn e,r c aiirrn t°nasisj
13, Re-opened Pric>r (dw.nrar-c:6c.airWrn bcnsnls)
14. Deer review
15Allenctanc:e ca'tii..n..nedicaf oiar hearings
16, urveiHarncwe
L. The Loss snforrnaluo n provided is obfained fror°rn the current Claims Adrninistrotor
on(: is accurate lc:alhe, best of the City's knowledge, Sees Exhibit A. The nur-r-iber I
ofcu':dc:airns the City of C'orl:us Christi has processed fror n '2017-2 2'.'' totr,nls of 3,006,
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11 o t Work
A. resinAdministration a r rr� r�ts���rasitatt tt s
1 . The Contractor ntractor will appoint a senior account represerntcative, line adjusters
and supervisory adjusters to serve solely in a rrnarnacgernec°nt and
administrative capacity. 1hese representatives shouid have at least five
years of experience in Workers' compensation and rr)L)St have experience
�
n a
in insurance matters for r.r,lurnic�Ja9 entities. sslpne c� account learn is to be
available; one month prior to the; sfcart ofthe contract to ensure a smooth
transition with the current Contractor. The person is expected to be
responsive daily to the City's administrative needs,
The Contractor's account tear ) must incUde one account executive, one
dedicated senior worker's' cornpensatoorn adjuster to handle indernnn"sty
clairrns with at least five years of experience in workers' compensation, with
experience in insurance rrnotters for municipalities, Additionally, the
contracting learn must also include, one clUalified, dedicated medical only
claims adjuster. Also, if is equally important to provide a list of Haack-up
personnel detailing, title, position, license and other designations should this
be required,
I Contractor shall provide a list of all servicing personnel on this account with
a current resurne of the designated odjuster(sj and backup adjuster who
will hondle:, City clairns. Arty additional personnel to be involved in City
clalrns handling of a later date shnoudd have a resurne submitted for prior
cor°isultation with the City, Mir.)irnu nn cluaMicotions 'for, personnel handling
City claims.
4, In the event an assigned adjuster be unable to perforrrn the assignE d deities
satisfactorily as determined by the City, immediate replacement of such �
adjuster is required, The City's Risk Manager will be consulted in decisions
regarding adjusters who will be, harn HncCity clairns
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RFP Ternpbte 03/ 5/2022
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`;i, A copy of fhe C.rwrntia(,:tcar's t:arofessican aI sic:andardsw inckiding turnarc:um,'1
firne benchmark rTuust cac'con,af:ac:any the t:aroposoc .
"Ti.,lea c""ontrc clor>s 6,.ur:; urs of operation wiH be Monday flr(_,,u.h H�doy 8w00 a.rn,
f o 500 k>.rya,
7. The, Contractor wi91 c_.callec:.tand report ec°iata as recjr.4ed by Federal, State
andLocal t�ayn crr�rt�s c�rrca�c�tre�^ ktic--�tt�a�:cCra
car�w�tr�a� tcar;a�as�; rat ira�;car°�r�r�� t'inir�m��s for tl"�ic:rs r,kcraiu.a..r
w 4
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The Contractor shall provide a full rr:an flea of workers' CoR1per')SC1tior) C:16ir.Tas
l c:adminisiraflon services shall t:ae provided in accordance with all
requirements of thea Texas Labor Code„ Te,xcjs iMUrr.arrcer Code, Te,xc.,as
EDpartrrwuerit of insurance AcIrninistrafive Rules, and the;,, TexasWorkers'
Cornpensation Act,
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9. AH administrative fines, teas and legal expenses levied by the Texas
Department of Insurance, or easy other reg ulotory body for cany rnotters
under the contractor's confrol for falbre to comply ✓✓ith fhe Texas Workers'
Compensation Act and related rules shall be hondlead and paid by the
Contractor,
10, The Contractor shall follow all rules applicable to HCl" PA (early other sirs-illcar
law).
11. 1he Contractor shall act as the City's designated Reporting Agency for
Secfion 111 : Mandatory Re orfing for Medicare, and Medicaid extension
Act of 2007.
I aatrrr + ras
12. The Confractor Ml provide an on-ding, web-based computer claims
services and trac.;king ystern �to the City that includes, but is not limited to
diary narrative, supervisor and adjuster notes, and electronic access to
claims Tiles,The clairn systema must have a standar(:t statistical reporting
package,
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13. The claims system must be capable of generating IRS Form 10199 to vendors
and service providers as required by the InternaN Revenue Code, The
Contractor will forward the Forms 1099 as required by (.,)pplicabie law to the
IRSelectronically or magnetically based on IRS guidelines.
14. The c6airns systema rnusf be able to provide speacial/custornized I reports, arra
the City r"nustbe provided access to all clairns daia vwifh the capability to �
generate its own reporfs when needed. The clairn breakdown is lo include, �
RFP Ti`e r)C_flote 03/15/2022
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DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
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but not h::)e lirnite:d fo deportment ;accicae,nt
c::ode,% cicairn ant cage, gender carrot occupation; c.:Ycalrrr save:;^rify, kne oaf
coverage-,e , lairnon experience Ieve l; firn of (Jay, week, and year (-.;J
rac;cidolrflf and 'lypesof equipment nt invoN,ed.
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. , he:auld ea c k.flrns daalc:a r.e�.: nve.�rsoon be required, C:ontrcacfc:ar shall accurately
urately
�'onvert alY c lairns dale and e, ee€. tronr c: iirnaging from the Syste M of fhre°
ce,errE%r'rf vendor into use"babe claims files and provide~ the City access to �f
dcatca no longer than one; r,ncuanth'ro frcarn thre beginning oi Phe c:;carrtract period. �
I& The c-,A airn.s syste=m rrla.ast a,allc:>w the City to enter the first f(.,.�portof injury
ele.;c::trora'uccaily. The City wM deasigncafes its c:ar..rfhori e d t;ersonne i by
(,Je partrrre nt anc:f Contr, acltor shcaVl h)ema r.apcfated rnor..fl.h.11y.
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17'. All claims ores to be elect trc° nic/ ap rless.
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I& The Contractor shall scan and aftach gall cl airn docurnenfs to the electronic
c:;laina. Physical storage for halslorical workers' corrrponso iorc:lcairn films r-nusf
be provided.
19. Ther Contractor must have a corn rehte nsives business c:onfirw4uity/disaster
planter data recovery in orde=r to confirrl.aea daily operations.
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20, The Contractor will Utilize the same injury codes, classification codecs and 1
de partrnental codes as they City's curreyrrt system.
21 , All claims reported Linder the contract, including records only, rneadicof
only, indornnity clairrrs, and subrogation will be administered until fully
settled, regardless of the; period of time; involved or required, in accordance
with theafeao struc::turos indicated in the contract for services.
22. The Contractor will be responsible for handling subrogation cGairrrs ur°rtii
sottleadby a0l parties, Approvol of the City's Risk Manager is required before
discounting any Subrogation lien.
3, ae fflement of any c° airra requires the ooproval of thea City's Rsk, Manager.
4, The Contractor will notify than City's Risk Manager via ernail wil�Nn forty
dight
hours that a Benefit Review Conference or Contested Case Hearing
has been scheduled,
RFP Ierrplbie 03/15/2022
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
25. Citynl'Coesfirig ihe decision of anhea
y ring officer requires thE`,' a )Pr(
� )VCfl Of the
s Risk, NA(,inager,
26. (-I'ontra(,,tor shail allow the Cfy the opport(,.mity to po�Acip(,,ife iri regUkir
irc,.)ining sessions or serni n(:.Irs held for its ser,O( ing personne],
27, Upon expircflior,i or tern-Jriation of the ontracl resulting frorn this UP, within
thirty (Jays of the C''0y's request, al no cost to the Cily, the c;urrert
C(.")nfroc"lor shprovide rovide lhe, new Conlroctor with all dala retic U(-,sted by ilhe
City,
28, C(:)nlrac�or MI ind( ryinify arod prolecl ft,,e City agairisl errors or ornissions
corm witted by Ihe Contractor. Controct(,.)r ogrees to hcld the Oty harr-Ness
and to indemr)ify the ("Ity for all loss (.arising out of (.any coirns alleging on
error or ornission with respecf to the services performed by the Confr(:ictor,
29, Contractor shall cooperate cornpleiely with the City, City's lnsurance-
Broker of Record and ac jLJSters/atton,)eys of the excess 41SUrance carrier.
Contractor shall respond to iriquiries within one business day,
30. Contractor will rneel wifI-i the City's Safety and Risk monager al, a location
of the City's cf-ioosing cif least qUorlerly to review lhe) siotos or)d/or handling
of all open clairns and any o1her r-notters at the discretion of the City. An
annual stewardship rneeling will also be conducted.
B, Fund R
I . The City wHI make funds available that the Contractor may drow frorn for
indemnity and rnedical claims nnd/or loss or expense payments, The City
will hold all funds for outstanding claimsar,)d reserves, A loss fund will be
rnainloined in an amount agreeable to the Contractor and to ff-)e City,
2, AH payments made shall be made by issuance of checks from the
designated City--administered checking account established at fl")e City's
depository bank. The Contractor shall electronic oHy transmit a check
register to the Dty's Financial Services Department on a monthly basis. Such
check regisfer shall be transmitted by the Conirocfor no later than the
second business day o�f themonth following the rronth to this the check
register refers. 'Weekly check runs, flash reports and new clairrs report shall
be rnade in firnely fashion and submitted to the bUdgei analyst and Risk,
Manager every Monday morning prior to 12:00 p.m.
3, The Contractor shall transr-nit, via ernaH, the check number, check arnount
anddate of the check to the City's depository before a check is rnofled. In
lieu ofissuing stop payment requests, the Controcfor shall void the check
PPP femplae 03/C 5/2022
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
wlth tfre City's der..,rc..yr�l Ory o th�rcat ft,�e request e t tri (,Ae ryi o rT)Er rrt r��mnins ori
effect indefinitely.l . For each voicte(::t check the C ontrac t �
i y ��
crr shall transrnItr to 1
thea City^'sdchpository via edectronic Me transfer tic; check nurr)LDr, r, checz
c'ar°n(.:)cant can the date of the, r h.°re;c ,
f }
4. ft"re Cihy sh(:al! be responsible for b<:alondng and rec:cnciHng Paris 0C..c::crA-A
r�-)onfhl y, inc:.hr..,rcting pmc.essinc? of all unclaircr,c.,d Cl'-rE,c:k:s,
w ar will e`advis w , . . Y lc���.cast ctuarlcv,rly, � St tuS f
r The; Contractor � tPrr�; C�;it cat ��t � acr the � c�
oufstanc,�.fin c:'I,he�c.,ks so that ft�e Confract(-,�r rraya c.eterrnine Ihell,)EIr
pc1 rnenl S to any a e z sh)oud be voicJed and reissued <:,)r be processed
asurrc:;laiirrecwd property.
& Dup is ate payr enis of any type, whic t-� are unrecovered d by the Con trcwrctor
shall be reimbursed to that:', City by the Ccantrocwtcr.
7, I"he Contractor will furnish the City with rnontNy sun" mories of the bank
i
ac.;cc unt and expenditures, inclu ir-ig a list of all checks, vouchers and
voicdedchecks, in numerical sequence, The summaries r-nust include they
following:
laiMont Narne and Claim Number,
Date of Issue
a Payee
a type of Benefit Paid
Is erX efit Period
the Contractor will review open reserve s with the City's Risk
Manac ern-ionthly.
9. The Contractor will be SUbject to the approval of the; excess workers'
cornpenscation inSc.aranc.e company, if requesfect by the excess insurer, as
maybe appliar ble.
C. Claims Administration
I The C"ontrac,torwiH provide claims reporting services on a 24.-hourbasis.
I
2e Contractor shall create a fide within one working clay from receipt of the
initial report.
I The Contractor agrees fO use investigaf'ive forms provided by the City, or,
othervvise may furnish the forms to the City as may be necessary.
4, The Cor-rtrac..tor will investigate, reserve, adjust, seFttle, or decline all reported
RFP Ter"Y"iplat(,, 03/15/2022
I�
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
c:;Gcairiis in car:::(.-c:yrd(.:)n °.e \Wh state; workers' corrlt)ensPrvation statutes and
gen rcually r",ac°cepled clairns c.a 'pr.astung prcac:.fices.
I
eta The C;ontrcac:;tor sholi assign ca reported c�calr-n to on cacjUster wilNn 24 6µ.lOLAS
� c.>tthe`r ("'or-rtr°acmrtcar's rec:.e# of ncatic::Ye of injury,
6, The, assigned cac:tgost r will r r.ntac.:to or rattan runt to c onl acs t< (..'0 c,8crh"mr0s
w�thin 4 hours Of r°e cc ivir)g nofic;e of c Vrn pass nr-nent.
i
!, the C;oratrac:;tor wiH c'c:.)ni ac;t the injured earnployee:'s delD arfrnent orad
n-)edlccalfarovlder wifhin ivvo business days of not is ofaon of an irajW-y.
i
i
. The C`:on ircactor will obtain recorded stcaternents from c.Vn-t aints within Iwo
(2)business days of notlfwccatlon Of irajury. In addition, the C"I"onfractor will
obtciir'v'ecoordea(;t stcw:aternents fror"n any witness when there is ony Bost tlr-rea
lnvcalved inthe claire,
t
, The CConircactor will advise the City prior to denying any claimorpriorto fina9
disposition of any c l airn settlement that is outside the settlearnentc:uthorify �
granted to the Contractor by the City. Any request for sewttlemer,it
authority r declinations will be submitiedin writing to the City with the
following information:
0 A description of the fcac:ts and mature of the incident
desc"1r#ion of the dorso es and/or injuries
0 An evaluation of the incident �
a The cicalmant's demand
The arraount for which authority is requested
10.The City MI reserve the right to direct the handling of any cfoim or to take over
the handling of any claire of any lirnea during the lite of the service, agreernent
sand/or the; life of the claire only when raece.ssary,
1 1,The Contractor will monitor rnediccal treatment of injured employees and
obtainappro} riote medical reports.
1 , tura all claims, reserved in excess of $25,000, periodic written re-ports, of least bi-
monthly, will be provided by the C:ontractor/TPS, to City accompanied by any
pertinent file materials, As an alternative, C.;ontractor/.1.PA shall have the ability
to subrnit reports electronically Ghrough tf�)e lnforrraation Systern (IS)
t 3,.The Contractor WH keep all open claims on a current diary system, which
provides for periodic:: review by the crass' ned adjuster, E(.-acwh file shall be
reviewed and Updates s os necessary, but riot lass than once every 30 days.
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
i
1
i
1 .The Contractor Ml caudii r~a`rectic:.oc , hospiia: rwancd rrrlsc.,eHcaneo. ,,r s invoices prior io
approving foi p ayr-nent.
15.The City will refoin tine right to select its own me;cdccol service providers, os well
()sothers ufili ed for spec,eol clalryns handling procedures, inck.rsive c:af irnterrmrral
rnec:dicc:al resources; i,e- nurses pnrcacfitioners.
i
.The C'ontroctor well cauthor'l2;,, rrredlccal treofrnent carred indern nity benefits
c onslcm ered r('.0al rr , (.,Utcrry)ary and nec. ssay, l.sachecks or oath prize
payrnenis for treatment and benefits, The poyrrreni of indemnity and ry-'redical
benefits nnust be in accordance with the express authorlzcatlon lsryued by the
C;ityto the Craritractor.
1
17.The Contractorwill conduct an on-site investigation of any clairyr atfl")e request �
of the City wi'thlin hours of receiving the first notice of iris. At the discretion of
theCity, claimswith severe lass potential wik be- investi oted on the sarne day
the clalrra is reported.
1 ,The Cor-Jr-actor will prepare and provide the City with narrative reports for
seriousor contested injuries, when appropriate and asrequested any the City,
1 '.'The Cor-itractor will be alert and aggressively Pursue subrogation, excess insurance
reimbursement and third-party lions and n,-1ake every etfortto secure and pursue
the City's righis, of recovery.
0.The Contractor shall prepare and maintain files necessary for legal defense of
claims or l tigafion.
1, The Contractor, shall report all indemnity c loirrs to the; index Bureau upon filo
creation at no charge to the City with a copy to the file
2 .The Contractor will negotiate settlement with injured employees, their attorneys
orrepresentatives within the discretionary settlement authority,
2 .The Contracfor will consult with the City and defense attorneys in the
settlemento'f litigated claims, and provide and monitor files for, the defense and
outcome ofihese litigated claims.
A.The Contractor may assist in the recon mendatlon or Red .selection of defense
attor-ney(s); however, the City will retrain the richt to select the attorrrey(s) it
chooses.
25,The Contractor wiH be available to assist in the develotam erif and/or
RIF rfwarn[:k,'jte 03/r 5/2022
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
1 arr7�:, Ve: it°r'or. r uc tis n of written pmcedure.s car irustrUCc i0r°rs to assure r,lr.rr::ality oru(J
ongoing operation of they City's e.Ilcairns ra°'ucar)cagernc:;r.ut progrc;ar`ru.
I
t.3 QunlitControl
D. Contractr:ars must Nnve policies and procedures in place 'lo ensures and
rr�r�c sr. r�r�w,irrf�rrrwr: B cauapi y control. 'ff`e p oiir.:ies and prr:o. r.,durc�s s8-muld addl'EM OP
caspec::is ofthr.;a c.lcairyr�s handling process, irrc..luP,.airrg, but r)ot lirnite d for
I . CMlcair rs o,Jjusler/Sr,)f. erwls }r (:.ros loods for emr.floyerrs lic.i `illty and workers'
c;orr'"rpensation
. C:w lcairns file dac:;urnentation repuirerne nfs
3, WeMt—bosem d trcairairrc� farc:;agrcar�u uponrec.;luc=,t
. lnvestigation arid comrnunic.catiori
5. 9nihai contact with injured ernployee
6, Recorded statements
. Reserving guidelines
. Frequency of reviews of oper°i ra lairn reserves
. Deary system°I n"ioln nine d for a9l claire activities j
M Frequency of supervisor's review at each adjuster's c.lcairn files
11. Frequency of follow-up contacts with workers' ccrr'rpensatioru least-firne.e
claimants
12,Sul rogation procedures
13, Lifigcatian/attorney management
14, xpe.r�se controls of other vendors
15.Special investigation or surveillance procedures
16.Compliance with excess 'insurance reporting requirements
eat
17.General client serv'ic'ing reguirernents and guidelines
18, Index bwe:au clue.,ry and reporting guidelines
E. The Contractor will furnish administration manuals, irICluding instructions and all
necessary forms within 30 days following they effective date of the awarded
contract.
1.4 ua it Assurance
F. Ti.ue Contractor will be subject to periodic c:;lairns oudits by or) inctependent firm
cat the discretion of the City, The purpose of such on audit is to measure
cornplicnc:ewit h the agreed-upon claim-es adrrair'risfration servicing standards
desired by the City.
G. The City has the option to auditany or all files maintained by the Contractor
andrequireas adeclr.aate internal controls. The Contractor is r u�ir tcar�s�ict
e � nate it t rrac i c+ rwtrc l rc�ceu r s M rpt ct
the Cl from a,linv tvnp
financial loss
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
EXHUT A
Claim Type by Year No of CWmis ToW PaW Outstanding Total InCLIrred
2012 693 $1,834,656A7 $17,53014 $1,852,167.11
Medicaf Only- Cornj.Aex 9 Sf,39,86225 so 0D
Medwal Drily 636 S359,16832 so'X S359,168 32
lndemruty 46 $1,405,625,90 17,530 64 S1,423,156 54
2013 584 $1,399,725.07 MOO $1,399,725.07
Medical Only Cornp9ex 13 S73,024,91
so 00 $73,024 91
Medical Only 517 $221,798,03 $0,()0 $x'21,76.98,0:3
Indemn1y 5.1 $1,104,90213 $0.00 S'l,104,902,1.3
2014 567 $1,798„130.00 $0,00 $1,7'98,130.00
Repot-I ONy .1 SCAlo S(l 00 $o 00
Medical Only-Coinp�ex 9 S40 056 03 S000 $40,056,03
med�caO4 0y 492 $191,621,71 SCAM $191 621,71
lndernrkly 65 $1,566,452 26 So()() $1,566,452,26
2015 547 $2,074,54,9,89 $68,030.83 $2,142,580.72
Report Only 39 S0,00 so.00 S0 00
Medica@ Onky-Complex 22 $86 498.67 S0.00 $986,4963.67
Medical Only 427 $137,287.43 $0.00 $137,28743
Indemnify 59 $1,850,763,79 $68,03083 $1,918,794,62
2016 534 $1,653,151A7 $274,899.88 $1,928,051.35
Report Only 155 VU0 $000 S0.00
Medical Only-CorrgAex 30 $82.168.06 $0.00 $82,168,06
lledcal Only 304 $224,076 12 $0,00 S224,07612
InderTinfty 45 $1,346,907 29 S274,899.88 S1,621,807.I7
2017 622 $2,339,727,47 $25,596.68 $2,365,32415
Report Only 184 $0.00 $000 $0,00
MedicW Ony-Comp@cx 15 $76,586,03 $0,00 $76,58U3
fvledicaB Orfly 373 $252,363,31 $000 S252,363 31
krdemniCy I>0 $Y2,010,7'7,9. 3 !:)25,596,68 $2,036,374 81
2018 607 $2,151,933-89 $1,273,619.89 $3,425,553,78
Report Only 188 s0.00 $0.00 $0 D0
Medical Orny-Cornp�ex 13 $66,052,45 $0.00 $66,052 45
Medical ONy 358 $224,417'.83 S0 00 $224.417.83
Indernr6ty 48 $1,861,463,61 $1,273,(519.89 $3,135,083 50
2019 637 $1,981,998,73 $72,3919.97 $2,054,39810
Report Only 196 $0.00 S000 S100
Medical Only-Minor 1 $;'8.75 $0,00 58"75
Medical Only-Complex 2 $19,262.47 $000 $1926247
Wledir;al Only 386 S322,891.90 $0,00 $322,991.90
IndernrOy 52 $1,639,835,61 $721,3qq Sf7 S1,712,2:35.58
2020 912 $2,218,32162 $611,285..33 $2,8291,608.95
Report Drily 194 SOW $0,00 �,0,00
Medical Only 488 S320,92608 S12,219.24
5333,145,32
Indy rnnly 230 S1,897,:397.54 $599,06609 $2A96,463 63
2021 746 $1,346,31016 $1,629,981.12 $2,976,291.88
Report Only 168 MOD so])o $U0
Medical Only-M[nor 2 $98334 $0,00 $983.34
MeducaN Only 409 $225,0656.88 $88 184.06 $313,252.94
IndernnAy 167 $1,120,258,54 $1,541,797 06 $2,662,055,60
Grand Total; 6449 $118,798,50717 $3,973,344,34 $22,771,851.71
PFP Template 03/�5/2022
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
S Attachment E - Pricing Form
.._ ,
// � � . I� CITY CORPUS CHRISTI
Pricing Faun
CONTRACTS NTRe C:TS A PROCUREMENT
T
., ,° RFP No. 4119 Workers Compensation Third-Party
Administrator Services
PAGE t OF
TATE: April 20, 2022
TRISTAR Claims Management Services, Inc, _ t;
a
.w......... _..._._...._... ...__..w . .......... .. .......__ _......_.. ._ ._ .__... ....
_PROPOSER AUTFNa�RUb SidW4TURE
I. Refer to "Instructions to Proposers" and Contract Terms and Conditions before completing
proposal.
. Provide your best price for each item.
. In submitting this proposal, Proposer certifies that;
a. the prices in this proposal have been arrived at independently, without consultation,
communication, or agreement with any other Proposer or, competitor, for the purpose
of restricting competition with regard to prices;
b. Proposer is an Equal Opportunity Employer; and the Disclosure of Interest information
or) file with City's Contracts and Procurement office, pursuant to the Code of
Ordinances, is current and true.
c, Proposer has incorporated any changes issue through ,Addenda to the RFP in this
pricing.
it rra Description Unit Mµ Fee
Wo lrk#rs' Con:p n at oar
1 Indemnity _.._...__ .._.. ....._ Per claire
75*
_.._ _.. _ .._..... _.......__. ... ......,.
2 Medical - Only. Per claire 195`
3 R ; rt Only � � Per claim 0
R�rn-a�f� C:c�s � ,.
4Indemnity _..
Medical _.._ ._ Per claim 500 per year open
6 ... Other. Per cl�m ......_
_._._ _...___. .._._. Claim 5 Meal Only _._...... . µ _Per cla_ _
_�._.. l _._.. _..��� _._,w.. _..._..._.. ....._.__.
Ryan-1n Cart
..... lndemnrL .__..__ _ ... .. _._.. _ ......... Per clairn .... 500..
5' Other_._ __Y ___..___.._._. ....__..___...._._. - Per claim _. ._
Medical -- only Pea claim
... 75
10 Medical Case Managements Per...c�laim �95mmr�CD3 OO + Mileage.. ......_
-_._______ __ _. ...... .
1 1 Utilization Review Services Per Rlaim 160 00 per request
12
Nodical Bill
Audits Per claim $8,50
13 Use of 50 Physician Panel Network_......_. Per clair-n $825.w
__...._..._ . . ceer rrt _95 per hour
14 Rehabilitation Ser vi e5 s .....__ ... _._..... . ... .... ._._._.__.. _._ .__......PClaV.........___.._.. _ ..._..__._...
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
Item Description Unit Fee
Case Mono e* ent Services Pei' claim $95 per hour
16 ... Return to cork/Medical Provider Programs Per claire $Included in acwcess_... .._
17 Online Computer Services Per claim $included
13 Attending, DWC Hearin c s BRC andCCH),, Per claim Included
19 Attending Mediation l-learinrs _._._.. ....._ _.... ... Per claire $Included
20 Impairment Rating Review Per claim_..... $350 per request _
21 Pursuing Subroc ation Per claim $20% of net recover
22
a oanncar.. lalrras. _ __........._. _ Per clal.. .... .._$Run-in rate..... . . .
_ 2 .,_... Pear Review Per claim $250 + Provider tee
24IF'e-ecerfification
Attorne Fees Per claim s cost
_..__....?' _..... ... _.... . ..., $,At .Per claim Included in uta tee
......... _. _... _. _...
26Administrative Fee Per month $
500
_____J-1-,,.,,ll,,,,"-",--. .. .- -1.
Grandlotai
Per claims rates for a designated claims staff with caseload limits of 1501 per Indemnity adjuster and 25
per Medical Only adjuster. �
.f ,�
F i 0-10A AM
OR
*�*"F` i '1��,1° '�1r�:tarfrtr�i�r�l�t�t~�crrrr�~�IM°���wothlimit~�;~�rrrna�t°Irrc ��•tcrttr�t�r� r"t� fo�°r�r°th
Best and Final Offer:
Annual fee of$172,077 (includes Line Items 1 — 3, 7— 9, 16 -- 19, & 26) with a �
3% increase in Year 2 and a 4% increase in Year 3 — 5.
i
a
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DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
I
Attachment C -,Insurance Requirements
�� II
L l I L6 I`r'`...I UA CSI C__
w C
1 . :��r°rtrca(:.tr�ar r��u.ast rac:)�° r: or°r�rr°n����cca ward;; Underthis ��r�tr��(:�,r�)c.,��l r�rllaQ c�[d Ir�.zr�r(incc, 1
reqa,Jred her6n i.rc:as beearr cabl aired and approved by the City's Durk Pvt(.)riac er.
C`onr rcactor rn ust riot oIlow al)y subc ontr(::.iclor to c ornrne:rnccw °park, all I.
sir°rriticar insurance c required of ttµy , r.�tarec crtrcac.t��r has been so oL)Iaiu�ed,
Contrar for r-n st furnish to 1he City's PisInsuranceManager
'
ar�ct Contra
Administrator, two copies of c:>fIns r nctaLP : ale
pc _:° endorscmenfs showing taa following � iri ��r�a c.; a�erage by an
�
a.�luarIrcas an ecp (scrceptcuable firs the C� ty's RiskRisk i``�tcan atter, The C:it�e ra)ust
be
s
additional it-Tsar ct for the Generai L.icability and Auto Lirab lity �
policies endorsement,ment, tarso ca waiver cat subrogotion us required on all
applicablepolicies, Endorsements must be provided with Certificate of
Insurance, Project n arae carats/car nUrnber rraaast be Iistec. in C esc:r°iptian Box of
C0 ,
TYPE OF INSURANCE MINIMUM INSURANCE CE C ER GE
Bodily Injury and Property Damage
30- riders day notice of Per tare Larrenc.:e - aggregate
cancellation,ella tion, requires on all
certificates or by applicable policy
endorsements.
C errarr`erc:.ieal General Liability $1 ,000,000 Per Occurrence
nnc l uctina :
I . Commercial Broad Form
2. Premises -- Operations
. Products/ Completed Operations
4, Contractual Liability
. Independent Contractors
Pe_._rsa_n...a...l.._l.!.?Lr clvertisij Irwb'U
...... .w _ _. .... ..
AUTO LIABILITY (including) $500,000 Combined Single Limit
1 . Owned
a Hired & Non-owned
1 Rented & Lecased..._. c��� or�� Per�:Y�ir�� _. .__......
PROFESSIONAL LIABILRY $1
(Errors and missions) (Defc.msc costs nisi incIczded it°i face voQa. e
of he poIic y)
It ckz)i -°s made pt:;rik y, rine date must be
prior iea irac ptuon rat cagrk,ernen'k, hove
exieraded aer:taming period prcMsiorrs and
id rriitw,a cmy lir-6tcaiaosrs cegrudd r g who Is
.�insu ed.
RFP 1erT)pk.fl(- 03/15120,22
1
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
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C'RiME/EMPLOYEE D&Sf"iONESlY $1 ,000,000 Per (.—cu�rr�,��c� .. .
,.z z
I
i r-cntracto� sh ail name, the City of
C -,8`isti, Textus e:a5 toss Payee
Stfu6cary...
I
WORKERS'RKER'S' COMP1 NSATION 500MO 500=0 $500, i:O �
mpioyer's L.iob lity
{ i
t . Vra the eve, rrt of acc.idesnIs of any kir.rd relate°,d to this pry: ectr Contractor for rl,,us't
furnish the gist; Mcaraac er with copes of tail repor is of such ac;r i(Jents within t
stays of the ac:c idem.
d_dfic>nac (uirern.en.i.s -
1 . Applic�oble for paid employees, Conlroctor rraust obtain workers'
compensation coverage 1hrough~u a licensed insurance company. The
coverage ge must be written on a policy and nclorser-nents approved by the
Texas Department of Insurance, The workers' compensation coverage
,provided must be in an c�rnount scrfficient to assure that ail workers'
compensation obligations incurred by the Contractor will t��,��e prornptly met.
An All States endorsement shall be required if Contractor is not dorm cited in
the State of Texas,
2, Contractor shaH obtcair7 and Mainhain in fuH force ar)d effect for the duration
of this Contract, and any extension hereof, at contractor's sole expense,
insurance coverage written on an occurrence- dosis, by companies
authorized and adr )itted to do business in the State of Texas and with an A.M.
Best's rating of no loss than A- V11.
2. Contractor shall be required to submit repiacernent Certificwcrt(,, of Insurar-ice
to City at the address provided below within tern days of any change made
by the Contractor or as requested by the City. Contractor shall pay any costs
incurred resulfinct from said chances. AM notices under tt-a`ss Article shal8 be
given to City at the following address:
City of Corpus Christi
Attn: Risk Management
P.CJ, Box 9277
Corpus Christi, TX 78469-9277
Rrr" TerY)pVr'.-)te 03/1.5/2022
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
I
Contractor agrees that with respect to the above required insurance, all
insurance policies r° to contain or be endorsed to contain the following
required r isions:
i
hist the City arra;;! its officers, officials, erT,h loyees, and vok.,nteers, as
cjddifiarnal insureds by elndorsenre:ar-,itwith regard to operations,
COrrIpleted operations and ac:tiviti(:rs of cif on behialf of t@,.re nanre,d
ir)si,rcud perforryre(J under a:'ontra�c:t with the Cmm� ty, with ihe asXa..E'ptia.-�)n of
the workers` a°�or�i��ensation pclic:yy.
w Provide, for an enc.°lorsen'ierglth of the, `'otherin umnc;e" ckx,ise, sxhia H rmt
apply to the City of Corpus C:.hiris'fi where then City is an (-1i tdifional insured
shown on the pol�cyr
Workers' compensation ana:A err�rployer:s° liability policies will provide a
I waiver of subrogation in favor of the City; and
Provide 30 calendar days advance written notice directly to City of any
c oncellafion, noxi rer°rewal, material change or termination in coverage
and not loss than tewn calendar days advance written nc'rtic;'e for
nonpayr-neni of pre miury).
"i ithiri five; calendar days of a carucellatior,i, nor'r_renew al„ r oleriotl change, or
teuninalion of coverage, Contractor shall provide a replacement Certificate
of Insurance and applicable endorsements to City, City shall have the option
to suspend Contractor's perforrnc.)nce should there be a lapse in coverage at
any tirTie dUringthis con-fract. Faiiure to provide and to mointoin thio required
insurance shall constitute a rnaterial breach of th�s contract.
6. In addition to any other rerne-dies the Cihy rr)c:.Iy have upon Contractor's failure
to provide and maintain any insurance or policy endorsements to the extent
and within the time herein required, the City shall have the richt to order
Contractor to stop work hereunder, and/or withhold any poyrnent(s) which
became due to Contractor hereunder until Contractor demonstrates
cornpp iance with the requirements hereof.
T. Nothing herein contained shall be construed as limiting in any way the extent j
to which Contractor may be held responsible for payr-ne nts of domage::asx to
persons or property resulting fror'n Contractor's or its subcontractor's
performance of the work covered under this contract. �
I
. It is agreed that Contractor's insurance shall be deerried primary arld nan-
contrih;ut(-)ry wth respect to any insurance or self-insurance carr-ied by th (., City
of Corpus Christi for liability arising out of operations under this contract, �
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PFP T rn[rrc,;afc: 03/15/2022
i
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
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2022 Insurance Requirements
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errs. Req, Exhibit I Legal Dept,/Risk Management
Worker's Compensation TPS, Services
1/27/2022 Risk Management - LegoN Dept,
RFP Te;rnpr ate 03/15/2022
DocuSign Envelope ID:2F7B30B9-189E-447F-B4BF-4568B46526A9
Attachment D - Warranty Requirements
''No wwranty recju�red for fhis Ageer-nent,''