3-03 - Insurance Affidavit.pdf

This is an Insurance Affidavit form issued by the City of Lubbock, Texas, for use by bidders and offerors responding to a Printing MIS Software procurement. The affidavit requires bidders to certify that they have reviewed the insurance requirements specified in the bid/proposal document with their insurance agent or broker. Bidders must confirm their ability to furnish valid insurance certificates and endorsements meeting all specified requirements within ten business days of receiving notification of contract award from the City. The form requires completion of contractor information including business name, address, and email, as well as primary and secondary insurance agent/broker contact information.

The affidavit serves as a compliance verification document requiring an original signature from the contractor representative and must be submitted as part of the bid/proposal package. The City of Lubbock reserves the right to reject any bid and award the contract to another contractor if the contractor fails to meet the specified insurance requirements and timelines. Questions regarding insurance requirements should be directed to the Director of Purchasing & Contract Management at (806) 775-2572.