36C25218B1017-004.docx

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Edward Hines, Jr. VA Hospital Job Order Contract IDIQ
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36C25218B1017
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36C25218B1017 S02 - Attachment 3 - Surety Acknowledgement of Coefficient.docx

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36C25218B1017

Surety Acknowledgement of Coefficient To be completed if offered coefficient is less than 1.00 See Statement of Work Coefficient/Wage Determination

OFFEROR INSTRUCTIONS: Section A (if required) shall be completed by the bidder and submitted to their Surety requesting they complete and return to the bidder, and is included in the bid package. Note: failure to submit at time of bid will result in the bid being non-responsive.

Section A Prospective Contractor information:

Contractor Name:___________________________________________
Address:___________________________________________
___________________________________________
Point of Contact:___________________________________________
Telephone:___________________________________________
E-mail:___________________________________________
Coefficient Bid:Standard:________________Premium:____________________

SURETY INSTRUCTIONS: SECTION B shall be completed by the Surety and returned to the bidder such that it is included with their IFB bid package. The government expects reasonable coefficient(s) to accomplish the resulting task orders. Submitted coefficient(s) less than one (1.00) will require an acknowledgement from the bonding company that work will be bid and may be potentially accomplished at less than cost.

Surety Acknowledgement of coefficient less than 1.00:

Section B

Surety Name:________________________________________
Surety Address:________________________________________
________________________________________
Telephone:____________________________
E-mail:________________________________________
Name/Title:________________________________________
Signature:________________________________________

Attachment 3 Surety Acknowledgment

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