Attachment-3-Surety Form.docx
DOCX document 19 KB Posted
- Attached to
- Z2DA--WICHITA JOB ORDER CONTRACT (2024)
- Solicitation number
- 36C25524R0052
About this file
This document is a Surety Form for a federal contract opportunity. The form is to be completed by the offeror and submitted to the surety, who will then return it to the Department of Veterans Affairs Network Contracting Office no later than June 28, 2024. The form requests information about the contractor, including their bonding limit, aggregate amount, history of completed projects, and any issues with subcontractors or suppliers. This is related to Solicitation Number 36C25524R0052 for a Job Order Contract for construction services at the Wichita VA Medical Center. The contract will be awarded by the Department of Veterans Affairs Veterans Health Administration.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25524R0052 0002.docx | DOCX document | |
| Sign In Sheet for JOC Pre-Bid Meeting.pdf | ||
| 36C25524R0052 0001.docx | DOCX document | |
| Attachment 2 - Performance Relevancy Survey.docx | DOCX document | |
| Attachment 1 - Past Performance Questionnaire.docx | DOCX document | |
| 36C25524R0052_1.docx | DOCX document | |
| ATTACHMENT 4- Specification Section 01 35 26- Safety Requirements 05-01-24.pdf |
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Indefinite Delivery Indefinite Quantity – Job Order Contract (JOC) 36C25524R0052
ATTACHMENT 3
SURETY FORM
OFFEROR INSTRUCTIONS: To be completed by Offeror and submitted to Surety requesting they complete and return as indicated on Surety Instructions, by no later than June 28, 2024
Contractor Name: _____________________________________________________________
| Address: | ___________________________________________ | ||
| ___________________________________________ | |||
| Telephone: | ___________________________________________ |
Please complete below and return as per instructions no later than: June 28, 2024.
SURETY INSTRUCTIONS: To be completed by Surety and returned no later than June 28, 2024 with proposal to:
Department of Veterans Affairs Network Contracting Office 15 Attn: Sean Jackson, Contracting Officer Regular Mail: 3450 S 4th Street Trafficway Leavenworth KS 66048 or via e-mail to Sean.Jacskon@va.gov
| FedEx: | 3450 S 4th Street Trafficway | |
| Leavenworth KS 66048 |
Surety Name:__________________________________________________
| Surety Address: | ___________________________________________ | |
| ___________________________________________ | ||
| Telephone: _________________________ Facsimile: _____________________ |
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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