8-Exhibits Insurance Affidavit.pdf

PDF 201 KB Posted

Attached to
ON-CALL CONCRETE RELATED SERVICES-SMALL PROJECTS
Solicitation number
RFP 3845
Issued by
Riverside County, California

About this file

Written by GovTribe AI ·

This document is an Insurance Affidavit for RFP #3845, which requires a proposer/company to review and agree to specific insurance requirements dated May 2021. The affidavit obligates the proposing company to furnish all required insurance policies with designated limits, full endorsements, and waiver of subrogation for the full term of the agreement. The company must provide insurance certificates, endorsements, and waiver of subrogation within 14 calendar days of the District's award recommendation.

The document emphasizes that failure to maintain the specified insurance coverage will be grounds for contract termination. The proposer must either accept all terms and conditions as stated in the Insurance Requirements or explicitly detail any exceptions, additions, deletions, or modifications on a separate form. The affidavit requires an authorized representative's signature, printed name, company details, contact information, and provides a checkbox option for declining the terms if the proposer cannot meet the specified insurance requirements.

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INSURANCE AFFIDAVIT

RFP #3845

I, (Proposer/Company) have reviewed the Insurance Requirements (Rev. 05/2021) 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. 05/2021).

☐ Check here if you DO NOT accept terms and conditions as stated in the Insurance Requirements (05/2021). 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 052021 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_7:
Telephone:
Email:
Signature1_es_:signer:signature:

File details come from the government source that posted it. Updated .