36C25622R0141 EXHIBIT E R1.docx

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Z2DZ--520-23-2-7081-0001 - PROJ 520-22-167 - Upgrade Mechanical Systems
Solicitation number
36C25622R0141
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This document contains a surety form for a contractor bidding on the Department of Veterans Affairs project to upgrade mechanical systems at Project No. 520-22-167. The surety form requires information on the contractor's bonding history and claims experience. The surety must confirm the contractor's bonding limit for a single project and in aggregate, and disclose whether the surety has ever had to complete a project or pay subcontractors for the contractor. The related federal contract opportunity is solicitation number 36C25622R0141 to upgrade mechanical systems for Project No. 520-22-167, issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. Bids 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. 520-22-167 Upgrade Mechanical Systems 36C25622R0141

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 .