8-03 Insurance Affidavit.pdf
PDF 83 KB Posted
- Solicitation number
- RFP 26-19436-KM
- Issued by
- Hunt County, Texas
About this file
This is an Insurance Affidavit form issued by the City of Lubbock, Texas for RFP 26-19436-KM regarding Operations and Maintenance of Baggage Handling System. The affidavit requires bidders and offerors to certify that they have reviewed all insurance requirements specified in the bid/proposal document with their insurance agent or broker. Upon contract award notification, successful contractors must furnish valid insurance certificates and endorsements meeting all specified requirements within ten (10) business days. The form requires the contractor to provide their representative's signature, printed name, business name, address, and email address, along with contact information for both their insurance agent/broker firm and secondary insurance contact.
The document emphasizes that failure to meet the ten-business-day insurance certificate submission deadline provides grounds for the City to reject the bid and award the contract to another contractor. Bidders should direct questions regarding insurance requirements to the City of Lubbock's Director of Purchasing & Contract Management at (806) 775-2572. The affidavit serves as a contractual representation that the contractor acknowledges and accepts all insurance obligations outlined in the solicitation documents prior to award.
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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:
RFP 26-19436-KM
File details come from the government source that posted it. Updated .