EXHIBIT A - Insurance Carriers or Agents Acknowledgment Form.docx
DOCX document 46 KB Posted
- Solicitation number
- Q0017
- Issued by
- Suffolk County, New York
About this file
This document is an Insurance Carriers or Agents Acknowledgment Form from the Suffolk County Water Authority (SCWA) for a Request for Quotes (RFQ) for fabricating and delivering custom aluminum chlorine tank holders. The RFQ is scheduled for bid submission by June 5, 2025, at 11:00 AM EST, with the project targeting delivery by May 22, 2025. Bidders are required to submit proposals electronically through BidNetDirect.com and must complete a comprehensive insurance acknowledgment form that details various insurance coverage requirements, including automobile liability, general liability, excess liability, worker's compensation, and professional liability insurance.
The procurement process emphasizes vendor selection based on multiple factors, including price, vendor experience, responsibility, business enterprise status (such as Disadvantaged Business Enterprise or small local business), and overall value to SCWA. Bidders must provide detailed documentation, including submission of bids, terms and conditions, insurance requirements, subcontractor insurance agreements, pricing sheets, and production drawings. Questions about the RFQ must be submitted through BidNet or emailed to Steve Blevins, the Procurement Agent, no later than 72 hours before the response due date. The SCWA reserves the right to evaluate and select vendors based on comprehensive criteria that extend beyond mere pricing considerations.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Aluminum Passthrough-Layout1.pdf | ||
| SCWA Fabricate and Deliver Custom Aluminum Tank Holders.pdf | ||
| Cl2 Truck Containment-Layout1.pdf | ||
| EXHIBIT B - Contact Info.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
EXHIBIT A
Insurance Carrier or Agent's Acknowledgement
Project Description: RFQ No. _______ – __________________________________________________________________
Your Insurance Carrier or Agent must complete the Form below. You must complete the Bidder's Acknowledgment. This Form shall be returned with the Bid submission.
Insurance Agent:
NAME OF FIRM
Address:
Email:
Fax No.: Phone No.:
Please review the SCWA insurance requirements contained in this Contract which are listed in the Instructions to Bidders. Confirm that you have read these specific requirements (pay particular attention to required limits) and that you are complying with them by placing a check in the appropriate box.
1. Automobile Liability
1. Material is Delivered by common carrier
1. General Liability
1. Excess Liability
1. Vendor’s Endorsement
1. Worker’s Compensation
1. Owners and Contractors Protection Liability (OCP)
1. Professional Liability Insurance
1. Builders Risk or Installation Coverage Floater
1. Crime
We have reviewed the insurance requirements set forth in the above proposed contract and are capable of providing such insurance to our insured in accordance with such requirements in the event the contract is awarded to our insured and provided our insured pays the appropriate premium.
Dated: Sign:
Authorized Insurance Agent or Representative
Print Name:
BIDDER'S ACKNOWLEDGMENT
The Bidder herein acknowledges that he/she has reviewed the insurance requirements within this Contract and has considered the costs, if any, of procuring the required insurance and will be able to supply the insurance required as per the Contract, if awarded to the Bidder, at no additional cost to the SCWA.
Sign:
Officer of Company Print Name
(Failure To Have This Form Properly Filled Out and Signed by The Insurance Agent as Well as The Bidder May Result in Your Bid Being Considered Non-Responsive.)
image1.jpeg image2.emf
File details come from the government source that posted it. Updated .