TEMPLATE LETTER FORM to DIVERSE SUPPLIERSCalifornia Department of Insurance Insurance Diversity InitiativewwwinsurancecagovdiversityCAIDSinsurancecagovPage 1Insurance Diversity Initiative 2020 Cali ID: 864016
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1 2020 CALIFORNIA INSURANCE DIVERSITY SURV
2020 CALIFORNIA INSURANCE DIVERSITY SURVEY TEMPLATE LETTER & FORM to DIVERSE SUPPLIERS California Department of Insurance â Insurance Diversity In i tiative www.insurance.ca.gov/diversity CA.IDS@insurance.ca.gov Page 1 | Insurance Diversity Initiative | 2020 California Insurance Diversity Survey | 300 Capitol Mall, Suite 16000 - Sacramento, CA TEMPLATE LETTER TO DIVERSE SUPPLIER NOTE: This draft form letter was developed in response to insurance company requests. Use of this template is not mandatory and is intended to serve as a guide. INSURANCE COMPANY LETTERHEAD Date Name Company Address City, State, Zip Dear [insert contact or company name]: [Insurance company] is collecting data from our suppliers in order to comply with California Insurance Code section 927 et. seq. that requires insurance companies to report to the California Department of Insurance about the diversity of our supply chai n and procurement efforts. The California Insurance Diversity Survey ( CA IDS) requests information from insurance companies regarding procurement practices with diverse suppliers from the years 2018 and/or 2019 . In order for [insurance company] to report our data, we respectfully request that you return the enclosed form by [date] to [company email/physical address]. If you have any questions, please contact [name + contact]. Sincerely , Name Title Enclosure s 2020 CALIFORNIA INSURANCE DIVERSITY SURVEY TEMPLATE LETTER & FORM to DIVERSE SUPPLIERS California Department of Insurance â Insurance Diversity In i tiative www.insurance.ca.gov/diversity CA.IDS@insurance.ca.gov Page 2 | Insurance Diversity Initiative | 2020 California Insurance Diversity Survey | 300 Capitol Mall, Suite 16000 - Sacramento, CA TEMPLATE FORM TO DIVERSE SUPPLIER PART 1 A . Check all designations that apply to your business , below: â Women Business Enterprise (WBE) â Minority Business Enterprise (MBE) â African American â Asian/Pacific Islander â Hispanic/Latino â Native American â Multi - Ethnic â Disabled Veteran Business Enterprise (DVBE) â Veteran Owned Business Enterprise (VOBE) â Lesbian, Gay, Bisexual, Transgender Business Enterprise (LGBTBE) â Multi - Certified Business Enterprises (MCBE) - C heck all that apply . â WBE â MBE â DVBE â VOBE â LGBTBE B . Your companyâs headquarters or a majority of your companyâs workforce are located in: â California C . NOTE: If you do not check one of the boxes above, check here â and you do not need to complete the rest of this form. 2020 CALIFORNIA INSURANCE DIVERSITY SURVEY TEMPLATE LETTER & FORM to DIVERSE SUPPLIERS California Department of Insurance â Insurance Diversity In i tiative www.insurance.ca.gov/diversity CA.IDS@insurance.ca.gov Page 3 | Insurance Diversity Initiative | 2020 California Insurance Diversity Survey | 300 Capitol Mall, Suite 16000 - Sacramento, CA TEMPLATE FORM TO DIVERSE SUPPLIER PART 2 Instructions: If you checked off any box es to Part I: sub - sections A or B of this form , please provide the following for each contract of goods/services your business provided to our insurance company during c alendar y ear (s) 2018 and/or 2019. *Type s
2 of good (s) or services include: ï
of good (s) or services include: ï· Advertising/Marketing ï· Claims Services ï· Facilities ï· Financial/Investment services ï· Human Resources ï· Information Technology ï· Legal Services ï· Office Supplies ï· Print Services ï· Professional Services o I nclude : Actuarial services o Do Not Include : Legal Services ï· Real Estate ï· Telecom ï· Travel/Entertainment ï· Other â Please specify:___________ YEAR CONTRACT AMOUNT ($) T YPE OF GOOD OR SERVICE* 2020 CALIFORNIA INSURANCE DIVERSITY SURVEY TEMPLATE LETTER & FORM to DIVERSE SUPPLIERS California Department of Insurance Insurance Diversity In i tiative www.insurance.ca.gov/diversity CA.IDS@insurance.ca.gov Page 2 | Insurance Diversity Initiative | 2020 California Insurance Diversity Survey | 300 Capitol Mall, Suite 16000 - Sacramento, CA TEMPLATE FORM TO DIVERSE SUPPLIER PART 1 A . Check all designations that apply to your business , below: Women Business Enterprise (WBE) Minority Business Enterprise (MBE) African American Asian/Pacific Islander Hispanic/Latino Native American Multi - Ethnic Disabled Veteran Business Enterprise (DVBE) Veteran Owned Business Enterprise (VOBE) Lesbian, Gay, Bisexual, Transgender Business Enterprise (LGBTBE) Multi - Certified Business Enterprises (MCBE) - C heck all that apply . WBE MBE DVBE VOBE LGBTBE B . Your companyâs headquarters or a majority of your companyâs workforce are located in: California C . NOTE: If you do not check one of the boxes above, check here and you do not need to complete the rest of this form. 2020 CALIFORNIA INSURANCE DIVERSITY SURVEY TEMPLATE LETTER & FORM to DIVERSE SUPPLIERS California Department of Insurance Insurance Diversity In i tiative www.insurance.ca.gov/diversity CA.IDS@insurance.ca.gov Page 1 | Insurance Diversity Initiative | 2020 California Insurance Diversity Survey 300 Capitol Mall, Suite 1600 - Sacramento, CA TEMPLATE LETTER TO DIVERSE SUPPLIER NOTE: This draft form letter was developed in response to insurance company requests. Use of this template is not mandatory and is intended to serve as a guide. INSURANCE COMPANY LETTERHEAD Date Name Company Address City, State, Zip Dear [insert contact or company name]: [Insurance company] is collecting data from our suppliers in order to comply with California Insurance Code section 927 et. seq. that requires insurance companies to report to the California Department of Insurance about the diversity of our supply chai n and procurement efforts. The California Insurance Diversity Survey ( CA IDS) requests information from insurance companies regarding procurement practices with diverse suppliers from the years 2018 and/or 2019 . In order for [insurance company] to report our data, we respectfully request that you return the enclosed form by [date] to [company email/physical address]. If you have any questions, please contact [name + contact]. Sincerely , Name Title Enclosure s 2020 CALIFORNIA INSURANCE DIVERSITY SURVEY TEMPLATE LETTER & FORM to DIVERSE SUPPLIERS California Department of Insurance Insurance Diversity In i tiative www.insurance.ca.gov/diversity CA.IDS@insurance.ca.gov Page 3 | Insurance Diversity Initiative | 2020 California Insurance Diversity Survey
3 | 300 Capitol Mall, Suite 16000 - S
| 300 Capitol Mall, Suite 16000 - Sacramento, CA TEMPLATE FORM TO DIVERSE SUPPLIER PART 2 Instructions: If you checked off any box es to Part I: sub - sections A or B of this form , please provide the following for each contract of goods/services your business provided to our insurance company during c alendar y ear (s) 2018 and/or 2019. *Type s of good (s) or services include: Advertising/Marketing Claims Services Facilities Financial/Investment services Human Resources Information Technology Legal Services Office Supplies Print Services Professional Services o I nclude : Actuarial services o Do Not Include : Legal Services Real Estate Telecom Travel/Entertainment Other Please specify:___________ YEAR CONTRACT AMOUNT ($) T YPE OF GOOD OR SERVICE* 2020 CALIFORNIA INSURANCE DIVERSITY SURVEY TEMPLATE LETTER & FORM to DIVERSE SUPPLIERS California Department of Insurance Insurance Diversity In i tiative www.insurance.ca.gov/diversity CA.IDS@insurance.ca.gov Page 2 | Insurance Diversity Initiative | 2020 California Insurance Diversity Survey | 300 Capitol Mall, Suite 16000 - Sacramento, CA TEMPLATE FORM TO DIVERSE SUPPLIER PART 1 A . Check all designations that apply to your business , below: Women Business Enterprise (WBE) Minority Business Enterprise (MBE) African American Asian/Pacific Islander Hispanic/Latino Native American Multi - Ethnic Disabled Veteran Business Enterprise (DVBE) Veteran Owned Business Enterprise (VOBE) Lesbian, Gay, Bisexual, Transgender Business Enterprise (LGBTBE) Multi - Certified Business Enterprises (MCBE) - C heck all that apply . WBE MBE DVBE VOBE LGBTBE B . Your companyâs headquarters or a majority of your companyâs workforce are located in: California C . NOTE: If you do not check one of the boxes above, check here and you do not need to complete the rest of this form. 2020 CALIFORNIA INSURANCE DIVERSITY SURVEY TEMPLATE LETTER & FORM to DIVERSE SUPPLIERS California Department of Insurance Insurance Diversity In i tiative www.insurance.ca.gov/diversity CA.IDS@insurance.ca.gov Page 1 | Insurance Diversity Initiative | 2020 California Insurance Diversity Survey 300 Capitol Mall, Suite 1600 - Sacramento, CA TEMPLATE LETTER TO DIVERSE SUPPLIER NOTE: This draft form letter was developed in response to insurance company requests. Use of this template is not mandatory and is intended to serve as a guide. INSURANCE COMPANY LETTERHEAD Date Name Company Address City, State, Zip Dear [insert contact or company name]: [Insurance company] is collecting data from our suppliers in order to comply with California Insurance Code section 927 et. seq. that requires insurance companies to report to the California Department of Insurance about the diversity of our supply chai n and procurement efforts. The California Insurance Diversity Survey ( CA IDS) requests information from insurance companies regarding procurement practices with diverse suppliers from the years 2018 and/or 2019 . In order for [insurance company] to report our data, we respectfully request that you return the enclosed form by [date] to [company email/physical address]. If you have any questions, please contact [name + contact]. Sincerely , Name Title Enclosure s