6-Exhibits Insurance Affidavit.pdf
PDF 234 KB Posted
- Attached to
- DISTRICTWIDE HVAC UNIT REPLACEMENT State and local contract opportunity
- Solicitation number
- RFP 3863
- Issued by
- Riverside County, California
About this file
This document is an Insurance Affidavit for Request for Proposal (RFP) #3863, related to a district-level procurement process. The affidavit requires a proposer/company to review and agree to specific insurance requirements for the full term of the agreement. The proposer must commit to providing insurance certificates, endorsements, and waiver of subrogation within 14 calendar days of the District's award recommendation.
The affidavit stipulates that failure to maintain the specified insurance coverage will be grounds for contract termination. By signing, the proposer acknowledges and accepts all terms and conditions outlined in the Insurance Requirements (Rev. 06/2025). The document provides space for an authorized representative's signature, printed name, company details, contact information, and an option to note any exceptions to the insurance terms if the proposer does not fully accept the stated conditions.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 1-CARB Contractor Mobile Source Form.pdf | ||
| 11-RFP 3863 Districtwide AC Unit Replacements.pdf | ||
| 12-Exhibits Timeframe To Complete.pdf | ||
| 13-Exhibits Submittal Check Off List.pdf | ||
| 4-Exhibits Business References.pdf | ||
| 5-Exhibits Subcontractor.pdf | ||
| 7-Exhibits Additions Deletions Exceptions.pdf | ||
| 9-Exhibits Contractors CAL OSHA Compliance.pdf | ||
| 10-Exhibits Qualifications Experience.pdf | ||
| 2-Exhibits Business Information.pdf | ||
| 3-Exhibits Pricding Page.pdf | ||
| 8-Exhibits Process To Complete Work.pdf |
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Text version
INSURANCE AFFIDAVIT
RFP #3863
I, (Proposer/Company) have reviewed the Insurance Requirements (Rev. 06/2025) 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. 06/2025).
☐ Check here if you DO NOT accept terms and conditions as stated in the Insurance Requirements (06/2025). 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 062025 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_10: |
| Telephone: |
| Email: |
| Signature1_es_:signer:signature: |
File details come from the government source that posted it. Updated .