36C25625R0126 EXHIBIT E.docx

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Z2DA--Project 667-25-190 Install Isolation Valves, B1 (Con)
Solicitation number
36C25625R0126
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This document is a Surety Form for a Department of Veterans Affairs project (Project No. 667-25-190) involving installation of isolation valves on the domestic water system in Building 1. The form is designed to be completed by a surety company and submitted as part of the technical proposal package for solicitation 36C25625R0126. The form requires detailed information about the contractor's bonding history, including the length of bonding relationship, contractor rating, single project and aggregate bonding limits, and critical risk assessment questions regarding project completion, insurance liability, and payment history with subcontractors and suppliers.

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FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 667-25-190 Install Isolation Valves on Domestic Water System, BLDG 1 36C25625R0126

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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