36C25624R0052 EXHIBIT E.docx

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Z2DZ--CON 520-22-169 Upgrade Mechanical Systems, JACC, Eglin and PCY
Solicitation number
36C25624R0052
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This document contains a surety form for a contractor bidding on Project 520-22-169 to upgrade mechanical systems at three Department of Veterans Affairs locations. The form requests information from the contractor's surety including bonding limits, aggregate amounts, claims history, and refused coverage. The contractor must submit this completed form as part of its technical proposal. The related federal contract opportunity notice is for pre-solicitation of upgrades to mechanical systems at VA medical centers in Pensacola, Eglin Air Force Base, and Panama City, Florida.

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FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 520-22-169 Upgrade Mechanical Systems 36C25624R0052

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 .