36C25624R0098 EXHIBIT E.docx
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- Solicitation number
- 36C25624R0098
About this file
This document is a Surety Form that must be completed by the Offeror's Surety and submitted as part of the technical proposal package for Solicitation Number 36C25624R0098. The form requests information about the Offeror's contractor rating, bonding limits, and history of project completion, insurance refusals, and subcontractor/supplier complaints and non-payment issues. The Surety must provide this information to the Offeror to include in their proposal for the Z1DA--CON Project #667-24-155 Mammography Site Prep procurement, which is being conducted by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16.
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FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 667-24-155 Site Prep for Mammography 36C25624R0098
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 .