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Page 19 of 22 <br />FORM 4.03 QUESTIONNAIRE <br />Suppliers must submit responses that address all questions posed in this “Questionnaire.” Suppliers may <br />emphasize in their narrative any areas of their proposal that they believe exceed our requirements. <br />1. Qualifications and Relevant Experience <br />A. Briefly describe your company. Include how long the company has been in business, the <br />qualifications of your company as they apply to this RFP, and how long your entity has been <br />administering claims. <br />B. Please list and describe in detail your firm’s experience with municipalities and government <br />agencies in Washington State, as well as the expertise of each member of your account <br />management team with municipalities and governmental agencies in Washington State. <br />C. Provide details of your company’s financial status and stability. <br />D. Describe any other facets of your organization and your firm’s experience that are relevant to <br />this proposal, which have not been previously described and that you feel warrant <br />consideration. <br />E. Provide names, tenure, roles, and responsibilities for each key team member engaged in <br />providing the related services. <br />2. Technical Capability, Approach, and Capacity <br />A. How do you assign claims? Is it based on lines of liability? Please explain. <br />B. Please describe your claims tracking database and reporting capabilities. Do you allow the <br />client access to your system? <br />C. Describe your firm’s claims protocol, including response, investigation, establishment of <br />reserves, adjustment of claims, subrogation, monitoring of claims, settlement procedure, <br />litigation, and claims closure process. Please provide a copy of your claim investigation “best <br />practices” or written guidelines <br />D. Do you have local representatives who could respond in person to conduct a claims <br />investigation if required? <br />E. Describe your corporate policy on file retention, including the following: <br />• Length of time <br />• Paper or Electronic <br />• Access to files after contract termination <br />F. How does your firm monitor the quality of adjusters’ performance? <br />G. How are caseload levels monitored? <br />H. What standard reports are available, and what are the ad-hoc reporting capabilities of the <br />information system? <br />I. Does your firm intend to subcontract any portion of this contract? If so, please provide the <br />following: name of the firm(s), the percentage of work to be performed by each <br />subcontractor, and a description of the nature of work performed by each.