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APPENDIX C <br /> CITY OF ELK RIVER/Elk River Municipal Utility <br /> AGENT OF RECORD RFP RESPONSE FORM <br /> INFORMATION ON THE FIRM <br /> Name of Firm: <br /> Branch Office: National Office: (if applicable) <br /> Address: Address: <br /> List Prior Names of Business if changes have been made: <br /> Telephone Number of Office: FAX Number: <br /> Branch: Branch: <br /> National: National: <br /> Number of Years In Business: <br /> Describe your firm's experience and expertise regarding public entity risks by relating the markets to <br /> which the firm has access, the information technology capabilities of your firm, other public sector <br /> clients with whom you have a relationship and which of the clients are self-funded. <br /> Describe the steps you would take in reviewing our current program and designing changes in the <br /> program. Include specific techniques and procedures your firm may use to assist in identifying current <br /> and anticipated new loss exposures to the City/ERMU. Describe the Loss Control, Risk Management, <br /> Wellness and Legal service offered by your firm. <br /> What are the transition expectations if the City/ERMU uses your services? <br /> C-1 <br />