9-05 - Insurance Affidavit.pdf

This is an Insurance Affidavit form required by the City of Lubbock for bidders and offerors on the Quincy Park Public Improvement District (PID) Stormwater Drainage Improvement Project in Lubbock, Texas. The affidavit certifies that bidders have reviewed all insurance requirements contained in the bid/proposal document with their insurance agent or broker. Bidders who are awarded the contract must furnish a valid insurance certificate and endorsements meeting all specified requirements within ten (10) business days after notification of award by the City. The affidavit requires the contractor representative's original signature, printed name, business name, address, and email address, as well as contact information for the primary and secondary insurance agents or brokers.

The form serves as a prerequisite submission for contract award and establishes the contractor's commitment to comply with insurance obligations prior to contract execution. Bidders unable to meet the ten (10) business day insurance certificate deadline are subject to bid rejection, with the City retaining the right to award the contract to an alternative contractor. Questions regarding insurance requirements may be directed to the City of Lubbock's Director of Purchasing & Contract Management at (806) 775-2572.