36C25626R0031 EXHIBIT E.docx

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Z1DZ--502-23-707 Replace Wayfinding and Signage
Solicitation number
36C25626R0031
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This is a Surety Form template that offerors must complete and submit as part of their technical proposal package for the Department of Veterans Affairs Veterans Health Administration project to replace wayfinding and signage (Solicitation Number 36C25626R0031, Project No. 502-23-707).

The form requires contractors to provide their company information and designate a surety, who must then complete the remainder of the document. The surety must supply their name, address, and point of contact information, along with details regarding their bonding relationship with the contractor, including the length of time providing bonds, the contractor's rating, and single project and aggregate bonding limits. The form also requires the surety to disclose whether they have previously completed a project for the contractor, whether liability insurance has been refused, whether complaints of non-payment by subcontractors or suppliers have been made, and whether the surety has had to pay subcontractors or suppliers on the contractor's behalf. The form provides checkboxes for yes/no responses to these disclosure questions.

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FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 502-23-707 Replace Wayfinding and Signage 36C25626R0031

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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