6-03 - Insurance Affidavit.pdf
PDF 171 KB Posted
- Attached to
- HD City Vehicle Maintenance & Repairs
- Solicitation number
- ITB 26-19380-AE
- Issued by
- Hunt County, Texas
About this file
This is an Insurance Affidavit document required by the City of Lubbock, Texas, for bidders and offerors on the Heavy Duty City Vehicle Maintenance & Repairs contract opportunity. The affidavit serves as a certification that bidders have reviewed all insurance requirements specified in the bid/proposal documents in consultation with their insurance agent or broker. Bidders who are awarded the contract must furnish a valid insurance certificate with all required endorsements within ten business days of notification of award. The document requires bidders to provide their business name, address, email contact information, and details for their primary and secondary insurance agent or broker contacts, including firm name, contact person, phone number, and email address.
The City of Lubbock reserves the right to reject any bid/proposal if the bidder fails to meet the specified insurance requirements and timeframes. Bidders with questions regarding insurance requirements should contact the City of Lubbock Director of Purchasing & Contract Management at (806) 775-2572. The document does not specify particular insurance coverage amounts, types, or other pricing terms, as those details are contained in the main bid/proposal documents. Completion of this affidavit with an original signature from the contractor representative is mandatory for bid submission.
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Text version
To Be Completed by Bidder or Offeror
If the time requirement specified above is not met, the City has the right to reject this bid/proposal and award the contract to another contractor. If you have any questions concerning these requirements, please contact the Director of Purchasing & Contract Management for the City of Lubbock at (806)
775-2572.
NOTE TO CONTRACTOR
City of Lubbock
Insurance Requirement Affidavit
Project Number:
I, the undersigned Bidder/Offeror certify that the insurance requirements contained in this bid/proposal document have been reviewed by me and my Insurance Agent/Broker. If I am awarded this contract by the City of Lubbock (City), I will be able to, within ten (10) business days after being notified of such award by the City, furnish a valid insurance certificate and endorsements to the City meeting all of the requirements presented herein.
Contractor Representative (Original Signature) Contractor Representative (Printed)
Contractor’s Business Name:
(Print or Type)
Contractor’s Address:
Contractor’s Email Address:
INSURANCE AGENT/BROKER CONTACT INFORMATION
Firm Name:
Contact Name:
Phone No.: Email:
INSURANCE AGENT/BROKER CONTACT INFORMATION
Firm Name:
Contact Name:
Phone No.: Email:
184487 Typewritten Text
26-19380-AE
File details come from the government source that posted it. Updated .