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INSURANCE REQUIREMENT AFFIDAVIT <br />TO BE COMPLETED BY APPROPRIATE INSURANCE AGENT <br />MUST BE RETURNED AS PART OF BID <br />I, the undersigned agent, cert'ify that the insurance requirements contained in this bid <br />me with the below-identified <br />document have been reviewed bY the below-identifed <br />vendor/contractor/consultant/engineer/architect. if the vendor/contractor/consultant/engineer/architect is awarded thtifed o~ uch award, to <br />Paris, I will be able, within ten (10) workmg days after ben9 no <br />furnish a valid i urance certificate to the City meeting alt of the requirements contamed <br />in this bid.^ ~ <br />Agent's <br />CURTIS FENDLEY <br />Agent Name (Print or Type) <br />GENERAL LIABILITY-ADMIRINS. EXCESS - AMERICAN INTERNATIONAL SPECIALTY <br />Name of tnsurance Carrier COMMERCIAL AUTO -UNITED FIRE WORKERS COMP. - TEXAS MUTUAL <br />1705 LAMAR AVENIIE <br />Address of Agency <br />PARIS, TX. 75460 <br />Cit~/State <br />9 3-784-0836 <br />PqQPPIp,R%mAND SONS <br />Name of Vendor/Contractor/Consultant/Engineer/Architect (Print or Type) <br />~C./ K/I day of ~a.-,~---- <br />SUBSCRIBED AND SWORN TO before me this U <br />Notary Publ+c tate of Texas <br />NOTE TO AGENT: ndor If this time requirema the contraceto t he next owest bidder meet ngt he specifecat ons.o If <br />responsible and awa <br />you have any questions concerning these requirements, please contact the City of Paris a <br />(903) 785-7511. <br />