2-Statement of Insurability and Quote (OPS-2142).pdf
PDF 109 KB Posted
- Attached to
- HIPP NonFederal Home Repair Services
- Solicitation number
- BCZ26 - 00029595
- Issued by
- Dallas County, Texas
About this file
This is a Statement of Insurability and Quote form issued by the Office of Procurement Services for the City of Dallas in connection with the Home Improvement and Preservation Program (HIPP) NonFederal Home Repair Services contract opportunity in Texas. The form requires bidders and proposers to attest that they have reviewed the insurance requirements for the contract and commit to providing a valid certificate of insurance meeting all specified requirements within 15 days of award notification. Failure to meet this 15-day deadline authorizes the City of Dallas to reject the award. Bidders must submit either a quote for the cost of required insurance or proof of existing coverage from their insurance agent or broker as part of their proposal submission.
The form also includes an attestation section for authorized insurance representatives to confirm they have reviewed the insurance requirements, provided a quote, and verified that the bidder or proposer is capable of obtaining the required insurance. Questions regarding insurance requirements can be directed to the City of Dallas Risk Management Division at (214) 671-9041. This document serves as a critical submission requirement in the bidding process, ensuring that prospective contractors demonstrate insurability prior to contract award.
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Text version
OPS-FRM-2142 4/7/2025
Rev. 12.14.2021 Page 1 of 1
OFFICE OF PROCUREMENT SERVICES
STATEMENT OF INSURABILITY AND QUOTE
SOLICITATION INFORMATION
Business Name:
I, as the person(s) legally authorized to sign contracts for my company, hereby attest that I have reviewed the insurance requirements for this contract and agree to produce a valid certificate of insurance meeting all the insurance requirements within 15 days of award notification. If the 15-day requirement is not met, the City of Dallas has the right to reject the award.
Furthermore, I have sent the requirements to my insurance agent or broker, and I have attached a copy of the quote for the cost of the required insurance, or proof of coverage.
By submitting a bid or proposal, I certify the above statements are true.
INSURANCE INFORMATION
I, as the authorized representative of the insurance agency or brokerage firm, have reviewed the attached insurance requirements, provided a quote, and attest that the bidder or proposer listed above is able to obtain the required insurance.
Signature, name, and title of Insurance Representative:
Agency Name:
Signature Date
Printed Name Title
Questions concerning these requirements?
Please contact the City of Dallas Risk Management Division at (214) 671-9041.
File details come from the government source that posted it. Updated .