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3. Provide the contact names and telephone numbers of five (5) organizations in <br />the State of Minnesota as references for the City. Include the number of <br />participants for each group. (Preferably, the references should be <br />governmental units.) Include two groups that recently terminated coverage. <br />C. Conflict of Interest: <br />1. Disclose any conflicts or perceived conflicts of interest. <br />2. Identify what procedures your firm utilizes to identify and resolve conflicts of <br />interest. <br />D. Previous engagements with the City of Ramsey. <br />1. List of previous engagements with the City of Ramsey. <br />2. Describe what lead to the end of the engagement. <br />E. Proposed Fee for Services: <br />1. Explanation of compensation plans for your firm under this proposal including <br />all services to be included in that fee. <br />2. The proposal should contain the proposed fee for services in either a fixed <br />dollar amount or as a percentage of premiums paid for coverage. Fees are to <br />be maintained at the proposed level unless approval is given by the City <br />Council for a change in the fee structure or level. <br />3. List any additional service options and the fee structure for those services. <br />4. Indicate any alternate billing arrangements you would be willing to consider <br />and the circumstances under which they would be most appropriate. <br />F. Copies of the following items: <br />1. Errors and omissions coverage. <br />2. Business license. <br />3. Statement of compliance with federal and state laws. <br />4. Description of the firm's view of their responsibilities to the City in the <br />provision of benefits brokerage services. <br />13 <br />