Attachment 5 - Certificate of Availability.docx

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Roentgengraphic Interpreting Services
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N6264520QBREADER
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Attachment 5

CERTIFICATE OF AVAILABILITY

I, _________________ [NAME OF WORKER/PROVIDER] hereby certify that I have agreed to provide services as a _________________under this contract at (fill in the location) _________________ for

_________________ [NAME OF PRIME CONTRACTOR]. I am available to begin providing these services on

(fill in date) _________________, should the above named prime contractor be awarded this position.

____________________________________________________
Radiologist/B Reader SignatureDate

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