3-Statement of Insurability and Quote (OPS-2142).pdf

109 KB Posted

Attached to
Temporary Sanitation Field Labor
Solicitation number
BT25-00028774
Issued by
Dallas County, Texas

About this file

Written by GovTribe AI ·

This document is a Statement of Insurability and Quote form from the Office of Procurement Services for the City of Dallas, dated 4/7/2025. The form requires a business seeking to bid on a contract to certify its ability to meet the city's insurance requirements within 15 days of award notification. If the insurance requirements are not met within this timeframe, the City of Dallas reserves the right to reject the award.

The form is designed to be completed by both the bidding business and their insurance representative, who must attest to reviewing the insurance requirements and provide a quote or proof of coverage. The document includes spaces for the business name, signatures, agency information, and contact details for the City of Dallas Risk Management Division at (214) 671-9041 for any questions regarding the insurance requirements.

View the file

Other files

File Type Posted
1-Sample Contract.pdf PDF
5-01 - Temporary Sanitation Field Labor - Scope of Work.pdf PDF
2-03 - OPS-FRM-640 -Team Make-Up and Local Workforce Form.xlsx XLSX spreadsheet
4-02 - Standard Forms.pdf PDF
8-BTZ25-00028774 Temporary Sanitation Field Labor - Vendor List.xlsx XLSX spreadsheet
6-Contractor Ins Requirements-RR-250929-POM-17560- Temporary Sanitation Field Labor.pdf PDF
7-Exhibit 1 - Sanitation Locations.docx DOCX document

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

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 .