2-03 - Insurance Affidavit.pdf
PDF 105 KB Posted
- Attached to
- Hazardous Waste Collection and Disposal
- Solicitation number
- ITB 26-19408-SR
- Issued by
- Henderson County, Texas
About this file
This is an Insurance Affidavit document submitted by the City of Lubbock, Texas in connection with the Hazardous Waste Collection and Disposal contract opportunity. The affidavit serves as a required certification document for bidders participating in this procurement. The document establishes insurance requirements and attestations that bidders must provide as part of their bid submission to demonstrate compliance with the City's insurance standards and protective measures for hazardous waste handling operations.
The affidavit functions as a binding declaration wherein bidders affirm their ability to maintain appropriate insurance coverage throughout the contract term. This document is typically part of the bid package requirements and must be completed, signed, and notarized by authorized representatives of the bidding organization. The insurance affidavit ensures that selected contractors carry adequate coverage to protect the City of Lubbock against liability risks associated with hazardous waste collection, transportation, and disposal activities, thereby fulfilling essential risk management obligations for this specialized and potentially dangerous service.
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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:
26-19408-SR
File details come from the government source that posted it. Updated .