Attachment 10 Notification of Compliance with Insurance Requirements.docx
DOCX document 17 KB Posted
- Attached to
- Patient Grounds Transportation
- Solicitation number
- 36C25623Q0998
About this file
This document is an attachment containing a notification of compliance with insurance requirements form. The form requires the contractor to acknowledge reading and understanding the insurance requirements specified in the contract. It requires the contractor to maintain at least the types and amounts of insurance specified in the contract and any modifications or time extensions. The policies must contain an endorsement stating that any cancellation or material change adversely affecting the government's interest will not be effective for the period prescribed by the state's laws where the contract is performed, or for 30 days after the insurer or contractor provides written notice to the contracting officer, whichever is longer. The contractor must also maintain the state's workmen's compensation insurance or a letter of reciprocal agreement with another state for the entire performance period, including any modifications or time extensions. The contractor agrees to make copies of all subcontractors' proof of insurance available to the contracting officer upon request.
The related federal contract opportunity is a solicitation issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16 for patient grounds transportation services. The solicitation number and name are provided, along with the type and agency. No other details are included in the summary as the document is an attachment and does not specify products, response dates, or other salient information.
View the file
Other files
Show all 11
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTACHMENT 10 – NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS
NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS
The undersigned Contractor hereby acknowledges that he or she has read and understands the insurance requirements specified in this contract and hereby agrees (1) that such insurance will be maintained in at least the amounts and types specified in this contract and during any modifications and or time extensions granted thereto; (2) that the policies evidencing required insurance shall contain an endorsement to the effect that any cancellation or any material change adversely affecting the Government's interest shall not be effective for such period as the laws of the State in which this contract is to be performed prescribe, or until 30 days after the insurer or contractor gives written notice to the Contracting Officer, whichever period is longer; (3) that _MS_______________ (State) Workmen's Compensation Insurance, or letter of reciprocal agreement with another state, shall be maintained on this contract for and during the entire performance period and for any modifications and time extensions granted thereto; and (4) that a copy of all subcontractors’ proof of insurance shall be maintained and shall be made available to the Contracting Officer upon request. This agreement shall become a part of the above referenced contract file.
INSURANCE COMPANY(S): ____________________________________
(NAME[S]) (TELEPHONE NUMBER[S]): ______________________________________________
CONTRACTOR: ____________________________________________
(NAME): __________________________________________________
(ADDRESS): _______________________________________________
(AUTHORIZED SIGNATURE) (DATE): _______________________________________________
(TYPED NAME AND TITLE):________________________________________________________
File details come from the government source that posted it. Updated .