Attachment-3-Surety Form.pdf
PDF 109 KB Posted
- Attached to
- 589A6-25-JOC LEAVENWORTH VAMC
- Solicitation number
- 36C25525R0102
About this file
This document is a Surety Form (Attachment 3) for a Department of Veterans Affairs Indefinite Delivery Indefinite Quantity (IDIQ) Job Order Contract (JOC) with solicitation number 36C25525R0384. The form requires both the contractor and their surety to provide detailed financial and performance information, with a submission deadline of July 10, 2025. The form seeks comprehensive details about the contractor's bonding history, including duration of bonding relationship, contractor rating, bonding limits for single projects and aggregate amounts, and critical risk assessment questions about past project completions, insurance refusals, and payment issues with subcontractors or suppliers.
The form is to be submitted to the Network Contracting Office 15, specifically to Contracting Officer Timothy Parison, with submission options including regular mail and email to an address in Leavenworth, Kansas. The document is marked "FOR OFFICIAL USE ONLY" and contains source selection sensitive information, indicating it is part of a competitive procurement process for federal contract services.
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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)
36C25525R0384
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 July 10, 2025
Contractor Name: _____________________________________________________________
Address: ___________________________________________
Telephone: ___________________________________________
Please complete below and return as per instructions no later than: July 10, 2025
SURETY INSTRUCTIONS: To be completed by Surety and returned no later than July 10, 2025 with proposal to:
Department of Veterans Affairs Network Contracting Office 15 Attn: Timothy Parison, Contracting Officer
Regular Mail: 3450 S 4th Street Trafficway Leavenworth KS 66048 or via e-mail to timoth.parison@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 mailto:timoth.parison@va.gov
File details come from the government source that posted it. Updated .