Attachment-3-Surety Form.docx
DOCX document 19 KB Posted
- Attached to
- Z2DA--Columbia JOC Contract-2024-2029
- Solicitation number
- 36C25524R0054
About this file
The document provided is a Surety Form, which is an attachment to a solicitation for an Indefinite Delivery Indefinite Quantity (IDIQ) Job Order Contract (JOC) issued by the Department of Veterans Affairs (VA), Veterans Integrated Service Network 15. The Surety Form is to be completed by the offeror's surety company and returned no later than June 28, 2024. The form requests information about the surety's relationship with the contractor, including the length of time providing bonding, the contractor's rating, bonding limits, and any issues with the contractor such as non-payment or the surety having to complete a project. This information is required to be submitted with the proposal in response to Solicitation Number 36C25524R0054 for the Columbia VA Medical Center JOC Contract from 2024 to 2029.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25524R0054 0004.docx | DOCX document | |
| 36C25524R0054 0003.docx | DOCX document | |
| 36C25524R0054 0002.docx | DOCX document | |
| 36C25524R0054 0001.docx | DOCX document | |
| Attachment 1 - Past Performance Questionnaire.docx | DOCX document | |
| ATTACHMENT 4- Specification Section 01 35 26- Safety Requirements 05-01-24.pdf | ||
| 36C25524R0054_2.docx | DOCX document | |
| Attachment 2 - Performance Relevancy Survey.docx | DOCX document |
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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) 36C25524R0054
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 August 21, 2024.
Contractor Name: _____________________________________________________________
| Address: | ___________________________________________ | ||
| ___________________________________________ | |||
| Telephone: | ___________________________________________ |
Please complete below and return as per instructions no later than: August 21, 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: Jeanette Mathena, Contracting Officer Regular Mail: 3450 S 4th Street Trafficway Leavenworth KS 66048 or via e-mail to Jeanette.Mathena@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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