36C25619Q1100-007.docx

DOCX document 16 KB Posted

Attached to
SWITCHBOARD- TELEPHONE OPERATORS Federal contract opportunity
Solicitation number
36C25619Q1100
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

About this file

This document contains a notification of compliance with insurance requirements for federal contract number 36C256-19-Q-1100. The contract is set aside 100% for Service Disabled Veteran Owned Small Businesses to provide switchboard and telephone operator services for the Gulf Coast Veterans Health Care System located in Biloxi, Mississippi. The contractor must maintain at least the types and amounts of insurance specified in the contract and any modifications thereto. The insurance policies must contain an endorsement noting that any cancellation or material change will not take effect for the period prescribed by state law or until 30 days after the insurer or contractor provides written notice to the Contracting Officer, whichever is longer. The contractor must also maintain Mississippi Workmen's Compensation Insurance or a letter of reciprocal agreement with another state for the entire performance period of the contract and any extensions. The contractor must provide copies of all subcontractor insurance proofs upon request.

36C25619Q1100 ATTACHMENT F - NOTIFICATIO OF COMPLIANCE WITH INSURANCE.docx

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36C25619Q1100-0001001.pdf PDF
36C25619Q1100-0001000.docx DOCX document
36C25619Q1100-003.docx DOCX document
36C25619Q1100-004.docx DOCX document
36C25619Q1100-005.docx DOCX document
36C25619Q1100-006.docx DOCX document
36C25619Q1100-001.docx DOCX document
36C25619Q1100-002.pdf PDF
36C25619Q1100-008.pdf PDF
36C25619Q1100-000.docx DOCX document

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ATTACHMENT F – NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS

36C256-19-Q-1100

NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS

The undersigned Contractor hereby acknowledges that he or she has read and understands the insurance requirements specified in this contract and hereby agrees (1) that such insurance will be maintained in at least the amounts and types specified in this contract and during any modifications and or time extensions granted thereto; (2) that the policies evidencing required insurance shall contain an endorsement to the effect that any cancellation or any material change adversely affecting the Government's interest shall not be effective for such period as the laws of the State in which this contract is to be performed prescribe, or until 30 days after the insurer or contractor gives written notice to the Contracting Officer, whichever period is longer; (3) that ________________ (State) Workmen's Compensation Insurance, or letter of reciprocal agreement with another state, shall be maintained on this contract for and during the entire performance period and for any modifications and time extensions granted thereto; and (4) that a copy of all subcontractors’ proof of insurance shall be maintained and shall be made available to the Contracting Officer upon request. This agreement shall become a part of the above referenced contract file.

INSURANCE COMPANY(S): ____________________________________

(NAME[S]) (TELEPHONE NUMBER[S]): ______________________________________________

CONTRACTOR: ____________________________________________

(NAME): __________________________________________________

(ADDRESS): _______________________________________________

(AUTHORIZED SIGNATURE) (DATE): _______________________________________________

(TYPED NAME AND TITLE):________________________________________________________

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