ATTACHMENT 6 - NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS.docx
DOCX document 16 KB Posted
- Attached to
- Rx Reverse Distribution Federal contract opportunity
- Solicitation number
- 36C25622Q0508
About this file
This document contains an attachment notification of compliance with insurance requirements related to a federal solicitation for Rx reverse distribution services. The solicitation is issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. Responders must acknowledge reading and understanding the insurance requirements specified in the contract and agree to maintain at least the amounts and types of insurance coverage specified, as well as provide notice of any policy cancellations or changes. The notification of compliance with insurance requirements must include the responder's insurance company information, signature of an authorized official, and contact information.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25622Q0508 0001.pdf | ||
| Revised Statement of Work.docx | DOCX document | |
| ATTACHMENT 1 - HINDS COUNTY MS WD 15 5153 REV 16.pdf | ||
| ATTACHMENT 4 - PAST PERFORMACE QUESTIONAIRE.docx | DOCX document | |
| ATTACHMENT 3 - LIST OF PAST PERFORMANCE REFERENCES.docx | DOCX document | |
| ATTACHMENT 2- QUALITY ASSURAMCE sURVEILLANCE PLAN.docx | DOCX document | |
| ATTACHMENT 5 - CONTRACTOR CERTIFICATION.docx | DOCX document | |
| 36C25622Q0508.pdf |
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Text version
ATTACHMENT 6 – NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS
36C256-22-Q-0508
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 ________________ (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):________________________________________________________
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