2-Statement of Insurability and Quote (OPS-2142).pdf
PDF 109 KB Posted
- Attached to
- Withdrawn Materials
- Solicitation number
- BYZ26-00029907
- Issued by
- Dallas County, Texas
About this file
This is a Statement of Insurability and Quote form from the City of Dallas Office of Procurement Services, required as part of the procurement process for a five-year contract with two one-year renewal options for the collection, transportation, and resale of withdrawn library materials from the Dallas Public Library. The form requires bidders and proposers to attest that they have reviewed the insurance requirements for the contract and agree to provide a valid certificate of insurance meeting all specified requirements within 15 days of award notification. Failure to meet this 15-day deadline may result in the City of Dallas rejecting the award. Bidders must also demonstrate that they have provided insurance requirements to their insurance agent or broker and have attached a copy of the insurance quote or proof of current coverage with their bid or proposal submission.
The form additionally requires an authorized representative from the insurance agency or brokerage firm to review the attached insurance requirements, provide a quote, and attest that the bidder or proposer is able to obtain the required insurance. The City of Dallas Risk Management Division serves as the point of contact for questions regarding insurance requirements and can be reached at (214) 671-9041. Bidders should note that submission of a bid or proposal constitutes certification that all statements made on this form are true and accurate.
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Other files
| File | Type | Posted |
|---|---|---|
| 7-Attachment 1.pdf | ||
| 5-01 Specifications - Withdrawn Materials.pdf | ||
| 1-Sample Contract.pdf | ||
| 6-Addendum 1.pdf | ||
| 3-02 - Standard Forms.pdf | ||
| 4-Business Enterprise Hub Forms.docx | DOCX document |
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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 .