Attachment D. Notification of Compliance with Contract Insurance Requirements.pdf

PDF 2 MB Posted

Attached to
Replace Foam Fire Suppression System with Water Deluge System Federal contract opportunity
Solicitation number
FA309924R0008
Issued by
Department of the Air Force Air Education and Training Command

About this file

The document is Attachment D. Notification of Compliance with Contract Insurance Requirements. It is an acknowledgement from the contractor that they understand and will comply with the insurance requirements specified in the contract, including maintaining the required coverage levels, providing advance notice of any policy changes, and ensuring subcontractor insurance is also in place. The document includes details on the contractor's insurance company information and the contractor's contact details.

The related federal contract opportunity is to replace the existing high expansion foam fire suppression system with a water deluge system in an aircraft maintenance bay. The contract has a total period of performance of 245 calendar days, with two notices to proceed - 63 days for pre-construction submittals and 182 days for construction. The acquisition is a total small business set-aside with a NAICS code of 238220, and the government anticipates awarding a firm-fixed price contract.

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Notification of Compliance with Contract Insurance Requirements Page of The undersigned Contractor hereby acknowledges that he/she has read and understands the insurance requirements specified in this contract and hereby provides notification (1) that such insurance shall be maintained in at least the amounts and types as stated in FAR 28.307-2 and during any modifications and/or time extensions granted thereto; (2) that the required insurance policies shall contain an endorsement to the effect that any cancellation of material changes 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 thirty (30) calendar days after the insurer or contractor gives written notice to the Contracting Officer, whichever period is longer; (3) that Workers' 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/or time extensions granted thereto; and (4) that a copy of all subcontractors' proofs of required insurance shall be maintained and shall be made available to the Contracting Officer upon request. This agreement shall be a part of subject contract and shall be legally binding and enforceable at law.

Insurance Company Information Name:

Address:

Policy Number:

Telephone Number:

E-mail Address:

Contractor Information Name:

Address:

Telephone Number:

E-mail Address:

Authorized Signature 9.0.0.2.20120627.2.874785

CurrentPage:
PageCount:
TextField1:
State: TX
CoName:
CoAddress:
CoPolicyNumber:
CoPhoneNumber:
CoEmail:
Remove-Ins-Company:
Add an item:
TextField2:
Date:
Name:
Signature:

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