ATTACHMENT E NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS.docx
DOCX document 17 KB Posted
- Attached to
- H946--Potable Water System (Water Well) Monitoring to include inspection and maintenance
- Solicitation number
- 36C25623Q0729
About this file
This document is a notification of compliance with insurance requirements for federal contract 36C25623Q0729. The contractor acknowledges that they have read and understand the insurance requirements specified in the contract. They agree to maintain insurance in the amounts and types specified for the duration of the contract and any extensions. The policies will contain an endorsement stating that cancellation or any change adversely affecting the government's interests will not be effective for the period prescribed by state law where the contract is performed, or 30 days after the insurer or contractor provides written notice to the contracting officer, whichever is longer. The contractor also agrees to maintain state workers' compensation insurance or a letter of reciprocal agreement for the entire performance period of the contract, including any extensions, and provide copies of subcontractor insurance upon request. This agreement will become part of the contract file.
The related federal contract opportunity is solicitation 36C25623Q0729 for inspection and maintenance services of the potable water system, including a water well, at a Department of Veterans Affairs facility.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25623Q0729.docx | DOCX document | |
| ATTACHMENT B LIST OF PAST PERF REF.docx | DOCX document | |
| ATTACHMENT C PAST PERFORMANCE QUESTIONNAIRE.doc | DOC document | |
| ATTACHMENT A Hinds County MS WD 2015-5153 R20 dtd 12-27-2022.pdf | ||
| ATTACHMENT D CONTRACTOR CERTIFICATION.docx | DOCX document | |
| ATTACHMENT F QASP Water Well.docx | DOCX document |
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Text version
ATTACHMENT E NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS
36C25623Q0729
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 .