Office of Procurement and Contracts
900 SW Jackson St., Room 451 South
Topeka, KS 66612
DeAngela Burns-Wallace, Secretary
Laura Kelly, Governor
REQUEST FOR PROPOSAL (RFP)
Bid Event Number:
Period of Contract:
May 8, 2020
June 5, 2020, 2:00 PM
Various State Agencies
12:01 a.m., July 1, 2020 through 12:01 a.m., July 1, 2023
This Bid Event was recently posted to the Procurement and Contracts Internet website. The document can be
downloaded by going to the following website: http://admin.ks.gov/offices/procurement-and-contracts/
It shall be the bidder's responsibility to monitor this website on a regular basis for any changes/amendments.
Wherever and whenever the word “State” is used, it shall mean the Committee on Surety Bonds and Insurance
under whose authority this insurance will be purchased.
Event ID: EVT0007412
We submit a proposal to furnish statewide property insurance during the contract period in accordance with specifications.
I hereby certify that (we) do not have any substantial conflict of interest sufficient to influence the bidding
process on this bid. A conflict of substantial interest is one which a reasonable person would think would
compromise the open competitive bid process.
NAME OF INSURANCE COMPANY _______________________________________________
NAIC Number ____________________________________
*NAME OF AUTHORIZED REPRESENTATIVE
(Individual - not agency) ________________________________________________________
NAME OF AGENCY ___________________________________________________________
CITY ____________________ STATE ____________________ ZIP CODE _______________
TELEPHONE ________________________________ FAX ____________________________
*Such individual must be authorized by the Kansas Insurance Statutes and Regulations to represent the above named
The undersigned submits the attached bid to furnish the requirements during the contract period in accordance
with the specifications and attests this bidder is not in arrears in taxes due the State of Kansas. I hereby certify
that I (we) do not have any substantial conflict of interest sufficient to influence the bidding process on this bid.
A conflict of substantial interest is one which a reasonable person would think would compromise the open
competitive bid process.
Typed/Printed Name of Signature ________________________________Title_____________
Event ID: EVT0007412
TAX CLEARANCE INSTRUCTIONS
A “Tax Clearance” is a comprehensive tax account review to determine and ensure that the account is compliant with all
primary Kansas Tax Laws administered by the Kansas Department of Revenue (KDOR) Director of Taxation. Information
pertaining to a Tax Clearance is subject to change(s), which may arise as a result of a State Tax Audit, Federal Revenue
Agent Report, or other lawful adjustment(s).
To obtain a Tax Clearance Certificate, you must:
• Go to http://www.ksrevenue.org/taxclearance.html to request a Tax Clearance Certificate
• Return to the website the following working day to see if KDOR will issue the certificate
• If issued an official certificate, print it and attach it to your signed renewal document
• If denied a certificate, engage KDOR in a discussion about why a certificate wasn’t issued
Per KSA 75-3740-(c), the Director of Purchases may reject the bid of any bidder who is in arrears on taxes due the State
of Kansas. The Secretary of the Kansas Department of Revenue is authorized to exchange such information with the
Director of Purchases as is necessary to determine a bidder’s tax clearance status, notwithstanding any other provision of
law prohibiting disclosure of the contents of taxpayer records or information.
Please Note: Individual and business applications are available. For applications entered prior to 5:00 PM Monday
through Friday, results typically will be available the following business day. Tax clearance requests may be denied if the
request includes incomplete or incorrect information.
Please Note: You will need to sign back into the KDOR website to view and print the official tax clearance
Information about Tax Registration can be found at the following website:
IMMIGRATION REFORM & CONTROL
Event ID: EVT0007412
All Contractors are expected to comply with the Immigration and Reform Control Act of 1986 (IRCA), as may be
amended from time to time. This Act, with certain limitations, requires the verification of the employment status of all
individuals who were hired on or after November 6, 1986, by the Contractor as well as any subcontractor or sub-
subcontractor. The usual method of verification is through the Employment Verification (I-9) Form. With the submission
of this bid, the Contractor hereby certifies without exception that Contractor has complied with all federal and state laws
relating to immigration and reform. Any misrepresentation in this regard or any employment of persons not authorized to
work in the United States constitutes a material breach and, at the State’s option, may subject the contract to termination
and any applicable damages.
Contractor certifies that, should it be awarded a contract by the State, Contractor will comply with all applicable
federal and state laws, standards, orders and regulations affecting a person’s participation and eligibility in any program or
activity undertaken by the Contractor pursuant to this contract. Contractor further certifies that it will remain in compliance
throughout the term of the contract.
At the State’s request, Contractor is expected to produce to the State any documentation or other such evidence
to verify Contractor’s compliance with any provision, duty, certification, or the like under the contract.
Contractor agrees to include this Certification in contracts between itself and any subcontractors in connection
with the services performed under this contract.
Signature, Title of Contractor
Event ID: EVT0007412
Policy Regarding Sexual Harassment
WHEREAS, sexual harassment and retaliation for sexual harassment claims are unacceptable forms of discrimination
that must not be tolerated in the workplace; and
WHEREAS, state and federal employment discrimination laws prohibit sexual harassment and retaliation in the
WHEREAS, officers and employees of the State of Kansas are entitled to working conditions that are free from sexual
harassment, discrimination, and retaliation; and
WHEREAS, the Governor and all officers and employees of the State of Kansas should seek to foster a culture that does
not tolerate sexual harassment, retaliation, and unlawful discrimination.
NOW THEREFORE, pursuant to the authority vested in me as Governor of the State of Kansas, I hereby order as follows:
1. All Executive Branch department and agency heads shall have available, and shall regularly review and update at
least every three years or more frequently as necessary, their sexual harassment, discrimination, and retaliation
policies. Such policies shall include components for confidentiality and anonymous reporting, applicability to
intern positions, and training policies.
2. All Executive Branch department and agency heads shall ensure that their employees, interns, and contractors
have been notified of the state’s policy against sexual harassment, discrimination, or retaliation, and shall further
ensure that such persons are aware of the procedures for submitting a complaint of sexual harassment,
discrimination, or retaliation, including an anonymous complaint.
3. Executive Branch departments and agencies shall annually require training seminars regarding the policy against
sexual harassment, discrimination, or retaliation. All employees shall complete their initial training session
pursuant to this order by the end of the current fiscal year.
4. Within ninety (90) days of this order, all Executive Branch employees, interns, and contractors under the
jurisdiction of the Office of the Governor shall be provided a written copy of the policy against sexual harassment,
discrimination, and retaliation, and they shall execute a document agreeing and acknowledging that they are
aware of and will comply with the policy against sexual harassment, discrimination, and retaliation.
5. Matters involving any elected official, department or agency head, or any appointee of the Governor may be
investigated by independent legal counsel.
6. The Office of the Governor will require annual mandatory training seminars for all staff, employees, and interns in
the office regarding the policy against sexual harassment, discrimination, and retaliation, and shall maintain a
record of attendance.
7. Allegations of sexual harassment, discrimination, or retaliation within the Office of the Governor will be
investigated promptly, and violations of law or policy shall constitute grounds for disciplinary action, including
8. This Order is intended to supplement existing laws and regulations concerning sexual harassment and
discrimination, and shall not be interpreted to in any way diminish such laws and regulations. The Order provides
conduct requirements for covered persons, and is not intended to create any new right or benefit enforceable
against the State of Kansas.
9. Persons seeking to report violations of this Order, or guidance regarding the application or interpretation of this
Order, may contact the Office of the Governor regarding such matters.
Agreement to Comply with the Policy Against Sexual Harassment, Discrimination, and Retaliation.
I hereby acknowledge that I have received a copy of the State of Kansas Policy Against Sexual Harassment,
Discrimination, and Retaliation established by Executive Order 18-04 and agree to comply with the provisions of this
Signature and Date