2-03 - Insurance Affidavit.pdf

This is an Insurance Affidavit form issued by the City of Lubbock, Texas, for the Pest Control Services contract opportunity at Southeast and Northwest Water Reclamation Plants (ITB 26-19322-SR). The affidavit must be completed by bidders or offerors and certifies that the bidder has reviewed all insurance requirements contained in the bid/proposal document in consultation with their insurance agent or broker. Bidders who are awarded the contract must furnish a valid insurance certificate and endorsements meeting all specified requirements within ten business days of notification of award. The form requires the contractor representative's original signature, printed name, business name, address, and email address, as well as contact information for the insurance agent or broker.

The affidavit serves as a compliance document confirming the bidder's ability to meet the City's insurance requirements as a condition of contract award. Questions regarding insurance requirements should be directed to the Director of Purchasing & Contract Management for the City of Lubbock at (806) 775-2572. Failure to meet the ten-business-day insurance submission requirement provides the City with the right to reject the bid and award the contract to another contractor.