5-03 Insurance Affidavit.pdf

This is an Insurance Affidavit document required for bidders and offerors on a City of Lubbock, Texas hay harvesting contract. The affidavit serves as a certification that the bidder has reviewed all insurance requirements specified in the bid/proposal document in consultation with their insurance agent or broker. Bidders who are awarded the contract must furnish a valid insurance certificate and all required endorsements to the City within ten (10) business days of notification of award. The form requires the contractor to provide their business name, address, email address, and signature, along with contact information for their primary and secondary insurance agents or brokers, including firm name, contact person, phone number, and email address.

The affidavit is a mandatory submission component for the hay harvesting project, which requires contractors to perform labor, equipment operation, and related services to harvest hay crops on City-designated plots, including cutting, baling, removing bales, and stacking the finished product near the plots as directed by City personnel. Questions regarding insurance requirements should be directed to the Director of Purchasing & Contract Management for the City of Lubbock at (806) 775-2572. The City reserves the right to reject any bid/proposal and award the contract to another contractor if the time requirement for insurance certificate submission is not met.