ATTACHMENT 4 NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS.docx
DOCX document 17 KB Posted
- Attached to
- J065--Linear Accelerator Maintenance Federal contract opportunity
- Solicitation number
- 36C25623Q0011
About this file
This document is an attachment notifying compliance with insurance requirements for federal contract 36C256-23-Q-0011. The attachment requires the contractor to acknowledge and agree to maintain at least the types and amounts of insurance specified in the contract. This includes workers' compensation insurance for the state where the contract is performed. The contractor must provide notice of any insurance policy cancellation or material change affecting the government's interests. The contractor must also make available copies of subcontractor insurance proofs upon request. The agreement becomes part of the contract file. The related federal contract opportunity is solicitation number 36C25623Q0011 for linear accelerator maintenance radiation oncology services from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25623Q0011 0001.docx | DOCX document | |
| ATTACHMENT 1 LIST OF PAST PERFORMANCE REFERENCES.docx | DOCX document | |
| ATTACHMENT 3 CONTRACTOR CERTIFICATION.docx | DOCX document | |
| 36C25623Q0011.docx | DOCX document | |
| ATTACHMENT 2 PAST PERFORMACE QUESTIONAIRE.docx | DOCX document |
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Text version
ATTACHMENT 4 – NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS
36C256-23-Q-0011
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 .