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D II I I UJULLLLL <br />INSURANGE REQU(REMENT /aFFI___.. DAV~T <br /> <br />'f O BE COMPLETED BY APPROPRIATE INSURANCE AGENT <br />MUS7' E3E RETUf?NED AS PFl RT QF BID <br />1, the uridersigned agent, certify that the insuranceeequW i-nidtehisntibid <br />docurnent have been reviewed b,~ m <br />vendor/contractor/consuitantlengineer/architect. lf the below-identified the vendar/contractor/consultant/engineer/architect iS a.~er be ng not fied oftsuch award, to <br />Paris, I will be able, within ten (10) warking days <br />furnish a va(icf insuranCe cerkificate to the City rneeting aII af the requirei-nhets~ ° rdiingd <br />in this btd. u ance mpany will not agree to strlke t <br />J' n avor " on cancellation provisions <br />FENDLEY <br />Agent Name (Print orType) <br />Agenk's Signat e <br />c r T R a t~Tr._~_S L1-T.11.~ ~ nTv <br />CENTRAL NSURAN EftMPANY D <br />Name of (nsurance Carrier <br />pn R0x 459 <br />Acldress of Agency <br />PARIS TEXAS 75461-045 <br />City/State <br />90 - <br />Phone Number <br />_._u_.....~- <br />STEPHENS & SONS CONCRETE <br />Name of vendor/ContractorlConsultantlEngineer/Architect (Print or Type) <br />day of L9 al <br />SUBSCRIBED AND SW~RN TO before mo this ~ <br />~~r~i~. <br />Notary Publi Stale of Texas <br /> <br />NpYE 7"O AGENT: <br />If this time requirement Is not rnet, the City has the rlght to decfare this vendor non-ocif responsible and award the contract to tho next lowest bidd~ase confacththepC tyiaftPa is at <br />you have any questions concerning lhese requirements, p <br />(903) 785-7511. <br />