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t <br />BID RESPONSE FORMS <br />INSURANCE <br />(3 of 5) <br />Proposer and Insurance Agent Statement: <br />We understand the insurance requirements of these specifications. and the <br />evidence of insurability shall be provided prior to contract execution. If our client is <br />awarded this contract, we agree to provide the County with a thirty (30) day written <br />notice of any intent to amend, terminate, or non -renew coverage by the insuring <br />company. <br />Insurance Agency <br />Insurance Carrier: <br />Insurance Carrier: <br />Bid Submitted By: <br />Signed: <br />Name (Typed): <br />Address: <br />City State /Zip: <br />Signature of Bidder's Agent <br />Area Code/ Telephone #: <br />(RELATED BID INSURANCE CLAUSES) <br />Indemnity and Insurance: To the extent permitted by law the successful bidder shall <br />indemnify and save harmless the County, its officers, agents, employees and assigns from <br />and against all loss, damages, expenses and liability caused by an accident or other <br />occurrence resulting in bodily injury, including death, sickness and disease to any person; <br />or damage or destruction to property, real or personal; arising directly or indirectly from <br />operations, products or services rendered or purchased under this Invitation to Bid. <br />The successful bidder further agrees to purchase and maintain the following insurance <br />coverage's during the life of this contract .with an insurance company acceptable to <br />Cabarrus County authorized to do business in the State of North Carolina as follows: <br />14 <br />AO" number 2 <br />F -11 <br />