1-03 - Insurance Affidavit.pdf
PDF 199 KB Posted
- Attached to
- Landscape & Grounds Maintenance Services Patrol Division Station South - 14005 Indiana Ave.
- Solicitation number
- RFP 26-19365-SR
- Issued by
- Hunt County, Texas
About this file
This is an Insurance Affidavit form required by the City of Lubbock, Texas for a Request for Proposals (RFP 26-19365-SR) for Landscape & Grounds Maintenance Services at the Lubbock Police Department Patrol Division Station South located at 14005 Indiana Ave. The RFP seeks proposals for grounds maintenance, litter control, plant and tree maintenance, and structural and site cleanliness services. Bidders are required to complete and submit the affidavit as part of their proposal submission. A site visit is mandatory for interested proposers, with reservations available by calling 806-775-2171 or emailing SairaRivera@mylubbock.us.
Bidders and offerors must certify that they have reviewed the insurance requirements contained in the bid/proposal document in consultation with their insurance agent or broker. Upon contract award notification by the City, the successful contractor must furnish a valid insurance certificate and all required endorsements within ten business days. The affidavit requires contractor contact information, business name, address, and email, as well as insurance agent or broker contact details including firm name, contact person, phone number, and email. Questions regarding insurance requirements should be directed to the City of Lubbock Director of Purchasing & Contract Management at (806) 775-2572. The City reserves the right to reject any bid/proposal that fails to meet specified time requirements.
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Text version
To Be Completed by Bidder or Offeror
If the time requirement specified above is not met, the City has the right to reject this bid/proposal and award the contract to another contractor. If you have any questions concerning these requirements, please contact the Director of Purchasing & Contract Management for the City of Lubbock at (806)
775-2572.
NOTE TO CONTRACTOR
City of Lubbock
Insurance Requirement Affidavit
Project Number:
I, the undersigned Bidder/Offeror certify that the insurance requirements contained in this bid/proposal document have been reviewed by me and my Insurance Agent/Broker. If I am awarded this contract by the City of Lubbock (City), I will be able to, within ten (10) business days after being notified of such award by the City, furnish a valid insurance certificate and endorsements to the City meeting all of the requirements presented herein.
Contractor Representative (Original Signature) Contractor Representative (Printed)
Contractor’s Business Name:
(Print or Type)
Contractor’s Address:
Contractor’s Email Address:
INSURANCE AGENT/BROKER CONTACT INFORMATION
Firm Name:
Contact Name:
Phone No.: Email:
INSURANCE AGENT/BROKER CONTACT INFORMATION
Firm Name:
Contact Name:
Phone No.: Email:
RFP 26-19365-SR
File details come from the government source that posted it. Updated .