5-02 (02) - Insurance Affidavit.pdf

This is an Insurance Affidavit form required by the City of Lubbock, Texas for the Reconstruction of Upland Ave 34th to 50th - 22B Project. Bidders and offerors must complete this affidavit certifying that they have reviewed the insurance requirements specified in the bid/proposal document with their insurance agent or broker. The form requires the contractor to confirm their ability to furnish a valid insurance certificate and all required endorsements within ten business days of receiving notice of contract award from the City. The affidavit must include the contractor's original signature, printed name, business name, address, and email address, along with contact information for the primary and secondary insurance agent or broker, including firm name, contact name, phone number, and email address.

The City of Lubbock reserves the right to reject any bid or proposal if the contractor fails to meet the specified insurance requirements within the ten business day timeframe following award notification. Bidders should direct any questions regarding the insurance requirements to the Director of Purchasing & Contract Management for the City of Lubbock at (806) 775-2572. This form serves as a pre-award confirmation mechanism to ensure contractor compliance with all insurance obligations prior to contract execution and must be submitted as part of the sealed proposal response using the forms provided by the City.