Exhibit_L_-_Installation_Floater_Affidavit_26-B-59IF.docx
DOCX document 14 KB Posted
- Attached to
- El Portal Vehicular Beach Access Ramp
- Solicitation number
- 26-B-59IF
- Issued by
- Volusia County, Florida
About this file
This is an Installation Floater Affidavit form required by Volusia County, Florida for Invitation for Bid 26-B-59IF, which concerns the reconstruction of the El Portal Vehicular Beach Access Ramp in Daytona Beach Shores. The affidavit documents the insurance broker's attestation that they contacted three insurance companies to obtain Installation Floater or Builder's Risk insurance coverage with Flood coverage extensions—specifically including coverage for flood damage resulting from storm surge caused by named and unnamed storms—as required by Exhibit A of the ITB. The form requires the affiant to identify the three insurance companies contacted, confirm their inability to provide the required coverage, and obtain notarization with witness signatures. The affidavit serves as potential documentation of good-faith efforts to secure mandated insurance coverage for this beach and intracoastal waterway construction project, which involves demolition and reconstruction of seawall, ramp, curbing, and sidewalk infrastructure damaged during Hurricane Nicole.
The affidavit is a compliance and documentation tool within the bid submission process for a project with an estimated construction cost of $1,464,420.00. The form allows bidders to demonstrate due diligence in attempting to obtain specialized flood insurance coverage required for coastal construction work. This document is particularly relevant given the project's location in a hurricane-prone coastal zone and the specific flood-related risks associated with beach access reconstruction. The affidavit format provides Volusia County with verified evidence of market conditions regarding availability of specialized insurance products, which informs contract administration and risk management for this FEMA-funded federal compliance 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 26-B-59IF for El Portal Vehicular Beach Access Reconstruction. ITB 26-B-59IF requires the Contract Bidder to attain the insurance contained in Exhibit A of ITB 26-B-59IF 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 with a Flood coverage extension for ITB 26-B-59IF:
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 26-B-59IF.
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:
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