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State Contract Reporting System

Florida Department of Financial Services: F.A.C.T.S

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Contract Information

 

Summary

Agency Name: DEPARTMENT OF FINANCIAL SERVICES

Agency Contract ID: WC155

Long Title: Florida Self-Insurers Guaranty Association, Inc

Vendor Name: FLORIDA SELF-INSURERS GUARANTY

Total Contract Amount: $991,600.00

Total Budgetary Amount: $991,600.00

Total Payment To Date: $849,135.00

Date of Execution: 06/29/2020

General Description: "The work of Florida Self-Insurers Guaranty Association (FSIGA) is specified in sections 440.38 and 440.385, F.S., and applicable rules. FSIGA is required to (1) review apps to self insure; provide a letter of recommendation for approval or disapproval to the Department, (2) collect, review, and analyze financial statements and loss reserve information of its members; (3) review bond ratings of each member, (4) recommend withdrawal from the association if they no longer qualify, (5) collect and maintain required security deposits and excess insurance policies of members (current, withdrawn, and/or former), (6) provide updated information to the Department when changes to its members have occurred, (7) collect payroll reports and provide to the Department, (8) maintain records on association members (current, withdrawn, and/or former), and (9) provide written notice to members whose security deposit is in excess of Department rules.

Main Information

Agency Contract ID: WC155

FLAIR Contract ID: D1504

Short Title: FSIGA

Long Title: Florida Self-Insurers Guaranty Association, Inc

Contract Type: Standard Two Party Agreement by Statute

Contract Status: Closed or Expired

Date of Execution: 06/29/2020

Date of Beginning: 06/29/2020

Original End Date: 06/30/2022

New Ending Date: 06/30/2024

Agency Service Area: WC

Statutory Authority: 440.38 and 440.385

Contract Involves State or Federal Financial Assistance: No

Recipient Type:

Provide for Administrative Cost: No

Provide for Periodic Increase: No

Procurement Information

Authorized Advanced Payment: No

Method of Procurement: Exempt, Federal or state law prescribes with whom the agency must contract [s. 287.057 (11), FS]

State Term Contract ID:

Contract’s Exemption Justification: State law prescribes that DWC must contract with FSIGA.

Agency Reference Number:

Business Case Study Done: No

Legal Challenges to Procurement: No

Outsourcing / Capital Improvements

Was the Contracted Function Previously Performed by the State: No

Was the Contracted Function Considered for Insourcing back to the State: No

Did the Vendor Make Capital Improvements on State Property: No

Budget Information

Original Contract Amount: $495,800.00

Total Contract Amount: $991,600.00

Total Recurring Budgetary Amount: $495,800.00

Total Non-Recurring Budgetary Amount: $495,800.00

Total Budgetary Amount: $991,600.00

Total Unfunded Amount: $0.00

As of Date: 6/22/2023

Recurring Budgetary Amount Account Code Fiscal Year Effective Date FY Cost Accumulator Agency Amendment Reference
$495,800.00 43-20-2-795003-43600100-00-100777-00 07/01/2020 2020-2021


Non-Recurring Budgetary Amount Account Code Fiscal Year Effective Date FY Cost Accumulator Agency Amendment Reference
$247,900.00 43-20-2-795003-43600100-00-100777-00 07/01/2023 2023-2024 R2
$247,900.00 43-20-2-795003-43600100-00-100777-00 07/01/2022 2022-2023 R1A1

Contract Change

Change Type Amendment Amount Agency Amendment Reference Change Description Amendment Effective Date Amendment Execution Date New Ending Date
Renewal $247,900.00 R2 R2A2 07/01/2023 06/21/2023 06/30/2024
Renewal $247,900.00 R1A1 Amendment / Renewal 07/01/2022 06/22/2022 06/30/2023

Vendor

Name Line 1Name Line 2City State ZipMinority Vendor Designation
FLORIDA SELF-INSURERS GUARANTY TALLAHASSEE FL 323080000 Non-Minority

CFDA

No CFDA Codes found for the contract.

CSFA

No CSFA Codes found for the contract.
More Deliverable Number      Commodity/Service Type Major Deliverable Method of Payment
     
 Workmens insurance Excess Policy / Insurance. The price listed is per form. Fixed Fee / Unit Rate
     
 Workmens insurance Actuarial Report. The price listed is per form. Fixed Fee / Unit Rate
     
 Workmens insurance Financial Statement. The price listed is per form. Fixed Fee / Unit Rate
     
 Workmens insurance DFS-F2-SI-20: Outstanding Liability Report. The price listed is per form. Fixed Fee / Unit Rate
     
 Workmens insurance DFS-F2-SI-19: Certification of Servicing for Self-Insurers. The price listed is per form. Fixed Fee / Unit Rate
     
 Workmens insurance DFS-F2-SI-17: Unit Statistical Report. The price listed is per form. Fixed Fee / Unit Rate
     
 Workmens insurance DFS-F2-SI-5: Self-Insurers Payroll Report. The price listed is per form. Fixed Fee / Unit Rate
     
 Workmens insurance DFS-F2-SI-1: Application for Self-Insurance. The price listed is per form Fixed Fee / Unit Rate
 Displaying 1 to 8 of 8    


Payments are also referred to as expenditures (creating or incurring a legal obligation to disburse money) or disbursements (the payment of expenditures). Payments include disbursements and accounting adjustments made on a contract. Payments are always positive amounts while accounting adjustments may be positive or negative depending on the type of adjustment.

Payment Details

"Date" in the listing below indicates the date the payment voucher was recorded in the system, not the date the payment was issued.
More Fiscal Year Total Amount
     
 2023-2024 $207,715.00
     
 2022-2023 $198,575.00
     
 2021-2022 $211,610.00
     
 2020-2021 $231,235.00

If a payment or adjustment to a contract was made before July 1, 2012, the information may not be posted in this system.

Contract Documents


Click on the pdf icon or Agency Document Link to view the document
Document Type Document Reference # Executed Date Document Add Date Agency Document Link View
Original Contract Original Contract - D1504 06/29/2020 7/16/2020 2:04:53 PM
Renewal R1A1 06/22/2022 6/23/2022 10:18:09 AM
Renewal R2 06/21/2023 6/30/2023 11:22:12 AM


Audit results posted prior to June 30, 2012, appear in a summarized form. As of July 1, 2012, the audit reporting process was expanded to include additional questions and comments from the Bureau of Auditing. As audits are captured in electronic format, they will be posted to this system. If you are interested in seeing audit reports by Fiscal Year and Agency Action Plans, please click here to navigate to the Transparency Florida Contract Audit page.

  • No audits have been conducted on this contract at this time.
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