3-Statement of Insurability and Quote (OPS-2142).pdf
PDF 109 KB Posted
- Attached to
- Suspected Animal Cruelty
- Solicitation number
- BTZ25-00029032
- 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 related to a Suspected Animal Cruelty services contract. The document serves as an attestation that bidders have reviewed insurance requirements, communicated with their insurance agents or brokers regarding coverage needs, and have obtained quotes or proof of existing coverage for the required insurance. Bidders must certify that they can provide a valid certificate of insurance meeting all contract requirements within 15 days of award notification, with failure to meet this deadline resulting in potential rejection of the award by the City of Dallas.
The form requires authorized company representatives to sign and submit the document along with either an insurance quote or proof of current coverage. Additionally, an authorized representative from the bidder's insurance agency or brokerage firm must review the insurance requirements, provide a quote, and attest to the bidder's ability to obtain the required insurance. The form includes contact information for the City of Dallas Risk Management Division at (214) 671-9041 for questions regarding insurance requirements. This form is a prerequisite documentation requirement for participation in the City of Dallas's three-year Indefinite Delivery/Indefinite Quantity contract for animal cruelty victim services, which includes two one-year renewal options.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 1-Sample Contract.pdf | ||
| 4-02 - Standard Forms.pdf | ||
| 5-01 - Suspected Animal Cruelty Scope of Work.pdf | ||
| 2-03 - OPS-FRM-640 -Team Make-Up and Local Workforce Form.xlsx | XLSX spreadsheet | |
| 6-Attachement 1 - Insurance Requirements.pdf | ||
| 7-BTZ26-00029032 Suspected Animal Cruelty - Vendor List (3).xlsx | XLSX spreadsheet |
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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 .