4-Exhibits Insurance Affidavit.pdf

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Attached to
MICROWAVE POINT-TO-POINT LINK
Solicitation number
RFP 3897
Issued by
Riverside County, California

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This document is an Insurance Affidavit for Request for Proposal (RFP) #3897, which requires potential proposers to confirm their ability to meet specific insurance requirements. The affidavit mandates that the proposing company review the Insurance Requirements (Rev. 05/2021) and agree to provide all necessary insurance policies with designated limits, full endorsements, and waiver of subrogation for the full term of the agreement. The proposer must submit insurance certificates, endorsements, and waiver of subrogation within 14 calendar days of the District's award recommendation.

The document emphasizes that failure to maintain the specified coverage will be grounds for contract termination. Proposers must explicitly agree to all terms and conditions outlined in the Insurance Requirements, with an option to note exceptions if they do not fully accept the terms. The affidavit provides space for the authorized representative to sign, print their name, and include company details such as mailing address, telephone number, and email, indicating this is part of a formal procurement process requiring comprehensive insurance documentation.

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INSURANCE AFFIDAVIT

RFP #3897

I, (Proposer/Company) have reviewed the Insurance Requirements (Rev. 05/2021) in its entirety and agree to furnish all insurance policies with designated limits, along with full endorsements, and waiver of subrogation, as stated in this Request for Proposal for the full term of the agreement.

I hereby agree to provide copies of insurance certificates, endorsements, and waiver of subrogation within fourteen (14) calendar days of the District’s notification of recommendation of award.

I understand and confirm that our firm is able to provide and maintain the coverage as specified.

Failure to maintain said coverage shall be sufficient cause for contract termination and shall result in termination of the awarded contract.

I understand that by signing this document, I (Proposer/Company) agree to all terms and conditions as stated in the Insurance Requirements (Rev. 05/2021).

☐ Check here if you DO NOT accept terms and conditions as stated in the Insurance Requirements (05/2021). Detail all Exceptions in, Additions, Deletions and/or Exceptions Form.

Authorized Representative’s Signature Name Authorized Representative’s Printed Name

Company Name Date

Mailing Address Telephone

City, State, Zip Code Email

Requirements Rev 052021 in its entirety and agree to furnish all insurance policies with:
Check here if you DO NOT accept terms and conditions as stated in the Insurance: Off
Company Name:
Mailing Address:
City State Zip Code:
Authorized Representatives Printed Name:
Date_14:
Telephone:
Email:
Signature1_es_:signer:signature:

File details come from the government source that posted it. Updated .