36C25622R0086 EXHIBIT E R1.docx

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Z1DA--667-22-4-1447-0009 - Project 667-18-104 Replace roof
Solicitation number
36C25622R0086
Issued by

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This document contains an exhibit form for a surety bond to be submitted as part of a technical proposal for solicitation number 36C25622R0086. The form requests information from a surety about a contractor, including how long the surety has provided bonding, the contractor's rating, bonding limits for single and aggregate projects, and whether the surety has ever had to complete a project or pay subcontractors for the contractor. The related federal contract opportunity is to replace various roofs under project number 667-18-104 through the Department of Veterans Affairs Veterans Health Administration VISN 16. The solicitation number is 36C25622R0086 and the opportunity posting name is Z1DA--667-22-4-1447-0009.

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FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 667-18-104 Replace Various Roofs 36C25622R0086

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

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