2-03 - Insurance Affidavit.pdf

This is an Insurance Affidavit form required by the City of Lubbock, Texas for bidders and offerors participating in the competitive sealed bid process for Liquid Polymer for Sludge Handling at the City of Lubbock Southeast Water Reclamation Plant. The affidavit certifies that the bidder or offeror has reviewed the insurance requirements specified in the bid/proposal document with their insurance agent or broker. Upon contract award notification by the City, the successful contractor must furnish a valid insurance certificate and endorsements meeting all specified requirements within ten (10) business days. The form requires the contractor's original signature, printed name, business name, address, and email address, along with contact information for the primary and secondary insurance agent or broker, including firm name, contact person, phone number, and email.

The City of Lubbock reserves the right to reject any bid or proposal if the insurance requirements are not met within the specified timeframe and may award the contract to another contractor. Prospective bidders with questions regarding insurance requirements may contact the Director of Purchasing & Contract Management for the City of Lubbock at (806) 775-2572. This affidavit serves as a pre-award certification mechanism to ensure contractor compliance with insurance obligations prior to contract execution.