Service Provider Performance Evaluation - Insurance Consultant
    Please rate the effectiveness of service provided by the contractor listed below. If you have no opinion, or do not recall using or receiving the service, indicate not applicable (N/A).
 
1.
Contractor Company:
2.
Contact Person:
3.
Contract Anniversary:
4.
Service Provided to SELF:
       
    Activity Rating
      Poor -- 1 -- 2 -- 3 -- 4 -- 5 -- N/A -- Excellent
    CONTRACT TASKS  
5.
Develop and recommend insurance, other risk financing or loss funding programs, or techniques.
 1   2   3   4   5   N/A  
6.
Develop underwriting information, structure offerings to insurers and secure financially acceptable companies providing the optimum balance of coverage, scope, cost and service.
 1   2   3   4   5   N/A
7.
Design and update insurance wording for the Memorandum of Coverage to meet SELF’s needs.
 1   2   3   4   5   N/A
8.
At least 90 days prior to annual anniversary, prepare written report to SELF on renewal terms, conditions, other indications of market conditions and trends.
 1   2   3   4   5   N/A
9.
 Prepare written reports to SELF on rate, coverage or insurance carrier related issues and present to Board. 1   2   3   4   5   N/A
       
    COMMUNICATION  
10.
Ability to communicate thoughts and ideas orally and in written form, and have them understood by others; ability to carefully listen, observe, understand and respond to what is communicated by others; skill in preparing written documents in a thorough and professional manner; skill in preparing, articulating and presenting material in a public meeting.
 1   2   3   4   5   N/A
       
    INTERPERSONAL SKILLS  
11.
Ability to deal with people; skill in maintaining cooperative, friendly relations with the Board and members; skill in handling conflict and confrontation; skill in inspiring confidence in others.
 1   2   3   4   5   N/A
       
    FOLLOW THROUGH  
12.
Ability to not just accomplish goals and objectives as stated, but to provide additional value for members.
 1   2   3   4   5   N/A
       
13.
Specific examples or comments: