Exhibit_K_-_Installation_Floater_Affidavit_25-B-70IF.docx
DOCX document 14 KB Posted
- Attached to
- Hurricane Nicole Seawall Extensions and Repairs for 14th, 15th, and 29th Avenues in New Smyrna Beach
- Solicitation number
- 25-B-70IF
- Issued by
- Volusia County, Florida
About this file
This document is an Installation Floater Affidavit for Invitation to Bid (ITB) 25-B-70IF, involving a local government project in New Smyrna Beach, Florida. The project scope involves Hurricane Nicole Seawall Extensions and Repairs for 14th, 15th, and 29th Avenues, which requires specific insurance coverage. The affidavit documents an insurance broker's attempt to secure an Installation Floater or Builder's Risk insurance policy with a Flood coverage extension, specifically for storm surge coverage related to named and unnamed storms in a beach or intracoastal waterway construction context.
The affidavit serves as a formal documentation that the insurance broker contacted three unnamed insurance companies seeking the required insurance coverage, all of whom indicated they could not provide the necessary policy. The document is designed to be executed with witness signatures and notarization, serving as a formal record of the broker's due diligence in attempting to secure the mandated insurance coverage for the bidding contractor. The affidavit appears to be a critical component of the bid submission process, demonstrating the contractor's good faith effort to meet complex insurance requirements for a coastal construction project.
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Text version
STATE OF
COUNTY OF
BEFORE ME, the undersigned authority, authorized in the state and county aforesaid to take acknowledgements, personally appeared ______________ (affiant), who after being duly sworn deposes and says:
Affiant is the Insurance Broker for _______________ (Contract Bidder). Contract Bidder placed a bid for ITB 25-B-70IF for Hurricane Nicole Seawall Extensions and Repairs for 14th, 15th, and 29th Avenues in New Smyrna Beach, Florida. ITB 25-B-70IF requires the Contract Bidder to attain the insurance contained in Exhibit X of ITB 25-B-70IF which includes a requirement for either an Installation Floater or Builder’s Risk insurance policy with a Flood coverage extension which includes coverage for Flood resulting from storm surge caused by named and unnamed storms for a beach or intracoastal waterway construction project. On behalf of the Contract Bidder, I contacted the following three (3) insurance companies to attain Installation Floater and Builder’s Risk insurance coverage for ITB 25-B-70IF:
1.________________________________________________________________
2.________________________________________________________________
3.________________________________________________________________.
The three (3) companies listed above informed me that they are not able to provide Installation and Builder’s Risk insurance coverage policy with a Flood coverage extension to the Contract Bidder in support of ITB 25-B-70IF.
SIGNED, SEALED AND DELIVERED
IN THE PRESENCE OF:
Witness signature Print Name:
(Print Name)
Witness signature
(Print Name)
The foregoing instrument was acknowledged before me by means of [__]physical presence or [ ] online notarization this ____ day of _________, 202_, by ____________ ___who is personally known and/or produced ___________________ as identification and who being duly sworn, deposes and says that the aforementioned is true and correct to his or her best knowledge.
Notary Public signature
Print Name
My commission expires:
File details come from the government source that posted it. Updated .