9-RFP 3843 Insurance Affidavit.pdf
PDF 201 KB Posted
- Attached to
- Roll-Up Door Replacement
- Solicitation number
- RFP 3843
- Issued by
- Riverside County, California
About this file
This document is an Insurance Affidavit for RFP #3843, which requires proposers to review and agree to specific insurance requirements dated 05/2021. 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 proposer must provide insurance certificates, endorsements, and waiver of subrogation within fourteen calendar days of the District's notification of award recommendation.
The document emphasizes that failure to maintain the specified insurance coverage will be sufficient cause for contract termination. Proposers must confirm their ability to provide and maintain the required coverage, and they have the option to accept or reject the terms by checking the appropriate box. If rejecting the terms, the proposer must detail any exceptions, additions, deletions, or modifications on a separate form. The affidavit requires the authorized representative to sign and provide company details, including name, mailing address, telephone number, and email.
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Text version
INSURANCE AFFIDAVIT
RFP #3843
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_14: |
| Telephone: |
| Email: |
| Signature1_es_:signer:signature: |
File details come from the government source that posted it. Updated .