36C25620Q0375-005.docx
DOCX document Posted
- Attached to
- H146--629-20-1-690-0024, BPA: Water Management Program (VA256-16-A-0090) (VA-20-00019085)
- Solicitation number
- 36C25620Q0375
About this file
This document contains an attachment notification of compliance with insurance requirements related to a federal contract opportunity for potable water management services. The Department of Veterans Affairs Network Contracting Office 16 is seeking these services for the Southeast Louisiana Veterans Health Care System in New Orleans, Louisiana. The solicitation number is 36C25620Q0375 and is set aside for Service-Disabled Veteran Owned Small Businesses. Interested parties must be registered in the System for Award Management and Vendor Information Pages databases and certified in the VetBiz database if applicable. The contractor must acknowledge understanding of insurance requirements specified in the contract and agree to maintain required types and amounts of insurance, as well as provide notice for policy changes or cancellations.
36C25620Q0375 ATTACHMENT 4- NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS.docx
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25620Q0375-0002000.docx | DOCX document | |
| 36C25620Q0375-0001000.docx | DOCX document | |
| 36C25620Q0375-004.docx | DOCX document | |
| 36C25620Q0375-001.docx | DOCX document | |
| 36C25620Q0375-003.docx | DOCX document | |
| 36C25620Q0375-006.pdf | ||
| 36C25620Q0375-002.txt | TXT text file |
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Text version
ATTACHMENT 4 – NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS
36C25620Q0375
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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