Request for Fax Quote This Is Not an Order

REQUEST FOR FAX QUOTE THIS IS NOT AN ORDER

Please complete and return this form with your quotation

RETURN FAX NUMBER (540) 982-2703

GREAT ROANOKE TRANSIT COMPANY (GRTC)

d/b/a VALLEY METRO

1108 Campbell Avenue, S.E.

Roanoke, Virginia 24013

DATE: 5/4/2018
FQ # 18GRTCEPR
Title: Executive Risk Insurance / RESPOND BY: June 12, 2017
(if your response is not received by 2:00 p.m. on ____June 12, 2018, your quotation may not be considered)
From: Tiffany Ollie, Director of Procurement Services
E-mail Address:
Telephone number: (540) 982-0305 ext 116
Fax number: (540) 982-2703 / DELIVERY IS F.O.B. DESTINATION UNLESS OTHERWISE STATED BELOW.
Specifications- Attachment A
Insurance Requirements- Attachment B
Purchase Order Terms and Conditions- Attachment C
Federal Transit Administration Terms, Conditions, and Certifications- Attachment D
PUBLIC NOTICE OF AWARD: Public notice of purchase order/ contract award will be posted at GRTC’s Administration Building on the first floor in the showcase at 1108 Campbell Avenue, S.E., Roanoke, Virginia 24013. The posting will also be posted on the Valley Metro website, Award information may also be obtained by contacting the purchasing agent whose name appears on this solicitation.
Description / Estimated Qty. / Unit of Measure / Bid Price
Employment Practices, Insured Persons and Organization, Fiduciary and Crime / 1 / Year
2 / Years
3 / Years
Total

*BID PRICE SHALL INCLUDE SHIPPING AND HANDLING CHARGES.

Please note that the estimated quantity listed in this Request for Fax Quote is an estimate only and is given for the information of Bidders and for the purpose of bid evaluation. This estimated quantity does not indicate the actual number of items that may be requested by GRTC.

NOTE: GRTC invites qualified Bidders to provide a bid. GRTC will review each response and may elect to issue separate awards to the lowest responsive and responsible Bidders for such items on a per items basis or any combination thereof that might be in the best interest of GRTC. A Bidder may submit a bid for one or more or all items listed on the Bid Form. Fax quote is good for 60 days.

EQUIPMENT SHALL BE DELIVERED TO GRTC AT 1108 CAMPBELL AVENUE, S.E., ROANOKE, VIRGINIA 24013 WITHIN 30 CONSECUTIVE CALENDAR DAYS FOLLOWING THE ISSUANCE OF A PURCHASE ORDER.

FULL LEGAL NAME (PRINT)
(Company name as it appears with your Federal Taxpayer Number) / FEDERAL TAXPAYER NUMBER (ID#) / DELEVERY DATE
BUSINESS NAME/ DBA NAME/ TA NAME
(If different than the Full Legal Name) / FEDERAL TAXPAYER NUMBER
(If different than the ID# above) / PAYMENTTERMS
Net 30
BILLING NAME
(Company name as it appears on your invoice) / FEDERAL TAXPAYER NUMBER
(If different than ID# above)
PURCHASE ORDER ADDRESS / PAYMENT ADDRESS
CONTACT NAME/ TITLE (PRINT) / SIGNATURE (IN INK) / DATE
E-MAIL ADDRESS / TELEPHONE NUMBER / TOLL FREE TELEPHONE NUMBER / FAX NUMBER
BUSINESS CLASSIFICATION ◊ LARGE ◊SMALL ◊ MINORITY –OWNED ◊WOMEN-OWNED

The attention of each Bidder is directed to Virginia Code Section 2.2-4311.2 which requires a bidder or offeror organized or authorized to transact business in the Commonwealth of Virginia pursuant to Title 13.1 or Title 50 of the Code of Virginia, as amended, or as otherwise required by law, shall include in its bid or proposal the Identification Number issued to such bidder or offeror by the Virginia State Corporation Commission (SCC). Furthermore, any bidder or offeror that is not required to be authorized to transact business in the Commonwealth of Virginia as a domestic or foreign business entity under title Title 13.1 or Title 50 or as otherwise required by law shall include in its bid or proposal a statement describing why the bidder or offeror is not required to be so authorized. Please complete the following by checking the appropriate line that applies and providing the requested information:

A.______Bidder/offeror is a Virginia business entity organized and authorized to transact business in Virginia by the SCC and such bidder’s/offeror’s Identification Number issued to it by the SCC is ______.

B._____Bidder/offeror is an out-of-state (foreign) business entity that is authorized to transact business in Virginia by the SCC and such bidder’s/offeror’s Identification Number issued to it by the SCC is ______.

C.______Bidder/offeror does not have an Identification Number issued to it by the SCC and such bidder/offeror is not required to be authorized to transact business in Virginia by the SCC for the following reason(s):

______

Please attach additional sheets of paper if you need to explain why such bidder/offeror is not required to be authorized to transact business in Virginia.

*Bid submittal shall include pages 1 and 19 & 20 if applicable of the Request for Fax Quote.

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK.

ATTACHMENT A TO

FAX QUOTE # 17GRTCEPR

Title: Executive Risk Liability

“If the vendor wishes to add, detract, substitute or otherwise modify the content of said terms and conditions, in part or in whole, such additions, detractions, substitutions, or modifications must be conveyed to GRTC in writing five (5) business days prior to the due date and time for bids for this solicitation. During this five (5) day period, the vendor and GRTC will in good faith attempt to reconcile the terms and conditions to the satisfaction of both parties. If the reconciliation is not achieved within the five (5) day period, GRTC is not obligated to come to terms with the vendor and reserves the right to engage the next lowest bid.”

BIDDERS SHALL PROVIDE THE DEALER SPECIFICATIONS FOR THE EQUIPMENT BEING BID IN THE BLANK LINES BELOW.

Executive Liability Specifications

Employment practices, Insured persons and organization and fiduciary liability

Named insured: / Greater Roanoke Transit Company
Additional insureds: /

• First Transit, Inc.
• SVTMC

Policy term: / July 1, 2018 to July 1, 2019
Optional Policy Terms: / July, 1, 2019 to July 1, 2020 (Two years)
July 1, 2020 to July 1, 2021 (Three years)
Coverage form: / Claims made and reported -Claims must first made against the insured during the policy period or, if elected, the extended period and reported to the insurance in writing.
Notable Endorsements: /

• Cap on losses from certified acts of terrorism
• General terms and conditions miscellaneous amendments
• Trade or economic sanctions endorsement

Notable exclusions: /

• Exclusion – Professional services errors & omissions
• Exclusion – Known wrongful act, fact, circumstance situation

Employment practices coverage part:

Employment practices liability / Insuring Clause 1: Employee Insuring Clause
Coverage applies for loss that the insured becomes legally obligated to pay by reason of an employment practices claim for an employment practices wrongful act.
Employment practices claim is defined as:
-a written demand against an insured for monetary damages or non-monetary or injunctive relieve
-a civil, judicial, administrative, regulatory or arbitration or mediation proceeding against an insured seeking monetary damages or non- monetary or injunctive relief, commenced by the service of a complaint or similar pleading, including any appeal therefrom
- a civil proceeding against an Insured before the Equal Employment Opportunity Commission or any similar federal state or local governmental body, commenced by the filing of a notice of charges, investigative order or similar document
-a criminal proceeding brought for an employment practices wrongful act against any insured
-a civil, criminal, administrative or regulatory investigation commenced by the service up or other receipt by any natural person insured of a written notice, investigative order or subpoena
- a written request of the insured to toll or waive a statute of limitations relating to a claim described above
Brought by or on behalf of an employee in his or her capacity as such.
Employment practices wrongful act means any actual or alleged:
-violation of any common or statutory federal state or local low prohibiting any kind of employment related discrimination
- harassment, including any type of sexual or gender harassment as well as racial, religious, sexual orientation, pregnancy, disability, age or national origin-based harassment or unlawful workplace harassment, including workplace harassment by any non-employee
- abusive or hostile work environment, including workplace bullying
-wrongful discharge or termination
-breach of actual or implied employment contract
- wrongful deprivation of a career opportunity, wrongful failure or refusal to employ, promote, or grant tenure, or wrongful demotion
- employment related defamation, libel, slander, disparagement, false imprisonment, misrepresentation, malicious prosecution, or invasion of privacy (including Unauthorized Access of Employee Information), or the giving of negative or defamatory statement in connection with an employee reference
- wrongful failure or refusal to adopt or enforce workplace or employment practices, policies or procedures
- wrongful discipline
- employment related wrongful infliction of emotional distress, mental anguish or humiliation
- retaliation
- negligent evaluation
- Negligent hiring, supervision, retention or training of others, but only if employment-related and claims by or on behalf of any employee and only if committed or allegedly committed by any of the Insureds in their capacity as such.
Insuring Clause 2. Third Party Claim:
Coverage applies for loss that the insured becomes legally obligated to pay by reason of a third party claim for a third party wrongful act.
Third party means any natural person who is a customer, vendor, service provider, client, or other business invitee of the organization, or any other natural person or group of natural persons, provided, however, Third Party shall not include any employee.
Limits: / $ 1,000,000Maximum aggregate for all loss incl Third Party Coverage
$250,000Special Event - Workplace Incident Fund
$250,000Special Event Fund
Retention : / $10,000each Employment Practices Claim
$5,000each Third Party Claim
Continuity date: / 07/01/2013
Extended reporting period: /

1. One year –100% of the premium
2. Two years – 125% of the premium
3. Three years – 150% of the premium

Notable Endorsements: /

• Unauthorized access of employment information - EPL
• Employment practices liability miscellaneous amendments
• EPL coverage section amended to include wage and hour claims costs, charges and expenses sublimit coverage only: Limit: $150,000 (For Multiple Plaintiff Claims)
• EPL coverage section amended to include wage and hour claims costs, charges and expenses sublimit coverage only: Limit: $150,000

Notable exclusions: /

• Exclusion – Professional services errors & omissions
• Exclusion – Known wrongful act, fact, circumstance situation

Insured persons and organization coverage part:
Insured Persons and Organization / Insuring Clause 1. Insured Person
Coverage applies to the loss of the insured persons for which the insured persons are not indemnified by the organization and which the insured persons have become legally obligated to pay for a wrongful act.
Insured Person is defined as an executive of any organization, employee of an organization or outside entity executive.
Insuring Clause 2 – Organization for which the Organization has indemnified the Insured Persons
Coverage applies to the loss of the organization for which the organization has indemnified the insured persons and which the insured persons have become legally obligated to for a wrongful act (defined above)
Insuring Clause 3 – Organization for which the Organization becomes legally obligated to pay
Coverage applies to the loss of the organization which the organization becomes legally obligated to pay for a wrongful act (defined above)
Limits: / $ / 1,000,000 / Aggregate limit
$ / 1,000,000 / Additional aggregate
$ / 2,000,000 / Maximum aggregate
Sublimit – part of and not in addition to the applicable aggregate limit
$1,000,000Government Funding
Retention — each claim: / $ / 0 / Insuring clause 1
$ / 5,000 / Each claim – Insurance clause 2 and 3
Continuity date: / 07/01/2013
Notable endorsements: /

• Government funding
• Additional Insureds Endorsement

• First Transit, Inc.
• Southwestern Virginia Transit Management Company, Inc. (SVTMC)

Fiduciary coverage part:
Insuring Clause 1. Fiduciary Liability
Coverage applies to the loss of the insureds which the insureds have become legally obligated to pay by reason of a claim for any wrongful act.
A)Covered Wrongful Acts include, with respect to a sponsored plan is defined as:
(1)Any actual or alleged breach of the responsibilities, obligations or duties imposed upon fiduciaries of the sponsored plan by ERISA, or by the Health Insurance Portability and Accountability Act of 1996, or any similar state or local common of statutory law, and ay rules and regulations promulgated under either of these Acts;
(2)Any other matter claimed against the sponsor organization of any of the insured persons solely because of the service of the sponsor organization of any of the insured persons as a fiduciary of any sponsored plain
(3)Any actual or alleged act, error or omission in the administration of any sponsored plan, including any actual or alleged violation of the Health Insurance Portability and Accountability Act of 1996.
Insuring Clause 2 – Voluntary Compliance Loss Coverage
Coverage applies to the loss which the insureds have become obligated to pay for any wrongful act for voluntary compliance loss and delinquent filer penalties and reimbursement of the voluntary fiduciary correction expense that the insureds have become legally obligated to pay for any wrongful act for a voluntary compliance loss.
Insuring Clause 3 – HIPAA Penalties
Coverage applies to HIPAA penalties of the insureds which the insureds have become legally obligated to pay by reason of a claim made against the insured for any wrongful act for HIPAA penalties.
Limits: / $ / 1,000,000 / Insuring Clause 1 – aggregate limit
$ / 25,000 / Insuring Clause 2 – aggregate limit
$ / 25,000 / Insuring Clause 3 – aggregate limit
$ / 1,000,000 / Maximum aggregate for all claims
Retention: / $ / 0 / Each claim
Continuity date: / 07/01/2014

**Loss runs are available upon request** Contact Tyneshia Wells 804-729-9812 or

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK.

ATTACHMENT C TO

FAX QUOTE # 18GRTCEPR

TITLE: Executive Risk Liability

PURCHASE ORDER TERMS AND CONDITIONS

1.Definitions.

GRTC- Greater Roanoke Transit Company (sometimes also referred to as the Buyer).

Items- All materials, goods, components, end products, data (including electronic data), work, and/orservices described in and/or called for by the Purchase Order.

Purchase Order or Order or Service Contract- The Purchase Order, Service Contract or other

Document (which can include an electronic document) issued by GRTC to obtain the items identified in such document.

Vendor- The person or entity to which the Purchase Order is directed and who will provide the items

identified therein (sometimes also referred to as Seller).

2.Invoicing.

All invoices shall be sent to:

Greater Roanoke Transit Company

1108 Campbell Avenue, S.E.

Roanoke, Virginia 24013

If any questions, contact Accounts Payable at (540) 982-0305 ext 114

3.Termination For Default and Convenience.

A.If Vendor refuses or fails to perform any of the terms of this Purchase Order, including poorServices, work, or materials, GRTC may, by written notice to Vendor, terminate this Purchase Order, in whole or in part. In addition to any right to terminate, GRTC mayenforce any remedy available at law or in equity in connection with such default, and Vendorshall be liable for all damages to GRTC resulting from Vendor’s default. GRTC furtherreserves the right to obtain immediately such items from other vendors in the event of Vendor’s default. Furthermore, GRTC may reject any items that do not comply with the requirements of this Purchase Order and any such items may be returned to Vendor atVendor’s sole cost and risk of loss.

B.GRTC may also terminate this purchase Order for convenience by giving written notice to Vendor at least 15 days prior to the effective date of cancellation. Any such termination shall be without liability of any type to GRTC except for payment for completed items delivered or services rendered to and accepted by GRTC.

C.GRTC may exercise GRTC’s right of setoff as to any amounts GRTC may owe the Vendor. GRTC may require Vendor to transfer title and deliver to GRTC any or all items procuredor produced by Vendor for performance of the work terminated.

4.Change By Vendor.

No changes, deletions or additions may be made by the Vendor to this Purchase Order, includingthe terms and conditions, without the express written approval of GRTC.

5.Changes By GRTC.

At any time GRTC may by written notice to Vendor make changes to the scope of this Purchase Order in any oneor more of the following: (1) drawings, designs, or specifications; (2) method of shipping/ packaging; (3) place of inspection, delivery or acceptance; and/or (4) quantity. Vendorshall proceed immediately to perform this Purchase Order as changed. If any such changes causesa material increase or decrease in the cost of the items, to the time required for performance of any part of the work required by this Purchase Order, GRTC and Vendor will agree upon an equitableadjustment in the price and/or delivery schedule. To qualify for adjustment consideration, Vendormust send written notice to GRTC of Vendor’s intent to file a claim under this clause within 14 calendar days from the date of receipt by Vendor of such written notice of change. Vendor shall proceed with the changed Purchase Order pending resolution of the claim for adjustment. GRTC may act on any such claim at any time prior to final payment under this Purchase Order. Nothing inthis clause shall excuse Vendor from proceeding with this Purchase Order as changed.

6.Payment.

The price(s) to be paid the Vendor shall be the current price(s) as stated on this Purchase Order. Unless otherwise stated in this Purchase Order, the price(s) shall include all applicable taxes and other charges such as packaging, shipping, duties, customs, tariffs and government imposedsurcharges. All personal property taxes assessable upon the items prior to the receipt and acceptance by GRTC of such items shall be borne by Vendor. GRTC will not be responsible for or pay for any items that may be ordered or received without an authorized Purchase Order number.

7.Sale Tax Exemption.

GRTC is exempt from payment of State Sales and Use Tax on all tangible personal property Purchased or leased for GRTC’s use or consumption. The Virginia Sales and Use Tax Certificate ofExemption number is 54-0982022.

8.Free on Board (F.O.B.), Risk of Loss and Title.

All prices are to be quoted F.O.B. Destination, Inside Delivery unless otherwise noted on this Purchase Order. The risk of loss from any casualty, regardless of cause, shall be on the Vendor until the items have been delivered to the place specified in the Purchase Order and acceptance byGRTC. The risk of loss shall also be on the Vendor during the return of any items to the Vendor. Title to the items shall pass to GRTC upon receipt and acceptance of such items by GRTC at the designated destination.

9.Inspection.

GRTC shall have a reasonable time after receipt of items and before payment to inspect all items for conformity to this Purchase Order. If all or some of the items delivered to GRTC do not fully conform with the provisions hereof, GRTC shall have the right to reject and return such non-conforming items.