ATTACHMENT D NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS.docx
DOCX document 17 KB Posted
- Attached to
- R499--RX Returns Federal contract opportunity
- Solicitation number
- 36C25623Q0208
About this file
This document is an attachment to a federal contract notifying of compliance with insurance requirements. The attachment requires the contractor to acknowledge and agree that the specified insurance in the contract will be maintained at or above the stated amounts and types. The policies must contain an endorsement noting that any cancellation or material change adversely affecting the government's interest will not be effective for the period prescribed by state law where the contract is performed, or for 30 days after the insurer or contractor provides written notice to the contracting officer, whichever is longer. The contractor must also maintain the specified state workers' compensation insurance or a letter of reciprocal agreement for the entire performance period of the contract, including any modifications or extensions. The contractor agrees to provide copies of all subcontractor proof of insurance to the contracting officer upon request, and this agreement will become part of the contract file.
The related federal contract opportunity is a solicitation from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16 for RX reverse distribution services, with the solicitation number 36C25623Q0208 and title R499--RX Returns.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25623Q0208 0001.docx | DOCX document | |
| Harrison Cty MS WD 2015-5147 R19 dtd 06-27-2022.pdf | ||
| ATTACHMENT B PAST PERFORMANCE QUESTIONNAIRE.doc | DOC document | |
| Escambia Cty FL WD 2015-4561 R21 dtd 07-29-2022.pdf | ||
| ATTACHMENT E QASP.docx | DOCX document | |
| ATTACHMENT C CONTRACTOR CERTIFICATION.docx | DOCX document | |
| ATTACHMENT A LIST OF PAST PERF REF.docx | DOCX document | |
| Bay County FL WD 2015-4559 R21 dtd 07-29-2022.pdf | ||
| 36C25623Q0208.docx | DOCX document |
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Text version
ATTACHMENT D – NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS
36C25623Q0208
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):________________________________________________________
File details come from the government source that posted it. Updated .