2-03 - Insurance Affidavit.pdf

This is an Insurance Affidavit form required by the City of Lubbock, Texas for bidders and offerors responding to the Granular Road Maintenance Salt procurement. Bidders who are awarded the contract must provide valid insurance certificates and endorsements meeting all specified requirements within ten (10) business days of receiving the award notification from the City. The affidavit requires the bidder or offeror to certify that insurance requirements have been reviewed with their insurance agent or broker prior to submission, confirming their ability to meet all insurance obligations outlined in the bid/proposal document. Bidders must complete the form with contractor representative signature, printed name, business name, address, and email address.

The form includes designated sections for primary and secondary insurance agent or broker contact information, including firm name, contact name, telephone number, and email address. Failure to meet the specified timeframe for providing valid insurance documentation gives the City of Lubbock the right to reject the bid and award the contract to another contractor. Questions regarding insurance requirements may be directed to the Director of Purchasing & Contract Management for the City of Lubbock at (806) 775-2572.