36C25622R0067 EXHIBIT E R1.docx
DOCX document 32 KB Posted
- Solicitation number
- 36C25622R0067
About this file
This document contains a surety form and details of a related federal contract opportunity for repair of a water distribution system at a Department of Veterans Affairs main hospital. The surety form requires contact and financial information from the surety company, including bonding limits, claims history, and confirmation of no refused liability insurance. The related federal contract opportunity is solicitation number 36C25622R0067 to upgrade the water distribution system at the main hospital for Veterans Integrated Service Network 16. Responses are due by the date specified on the surety form.
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FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 667-18-119 Repair Water Distribution System – Main Hospital 36C25622R0067
EXHIBIT E
SURETY FORM
OFFEROR INSTRUCTIONS: To be completed by Surety and SUBMITTED BY OFFEROR AS A PART OF THE TECHNICAL PROPOSAL PACKAGE.
Contractor Name:
Address:
Telephone: Email:
Please complete below and return no later than:
Surety Name:
Surety Address:
| POC: | Title: | |
| Telephone: | Email: |
How long have you provided bonding for the above contractor? YEARS What is the contractor’s rating?
| Bonding Limit for a single project? | $ |
| Aggregate amount? | $ |
Have you ever had to complete a project for the contractor? [ ] YES [ ] NO Has liability insurance ever been refused? [ ] YES [ ] NO Have there been complaints of non-payment by subcontractor/suppliers? [ ] YES [ ] NO Has the surety had to pay subcontractors/suppliers? [ ] YES [ ] NO
File details come from the government source that posted it. Updated .