ATTACHMENT F NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS.docx
DOCX document 17 KB Posted
- Attached to
- J039--Elevator Maintenance Federal contract opportunity
- Solicitation number
- 36C25622Q1322
About this file
This document is an attachment to a federal contract for elevator maintenance services. The contractor agrees to maintain insurance in the amounts specified in the contract and any extensions, including workers' compensation insurance. The insurance policies must contain an endorsement stating that cancellation or any change adversely affecting the government's interests will not be effective for 30 days or the period prescribed by state law, whichever is longer, without providing written notice to the contracting officer. The contractor must provide proof of insurance for any subcontractors upon request. The related federal contract opportunity is solicitation number 36C25622Q1322 for elevator repair and maintenance services issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25622Q1322 0002.docx | DOCX document | |
| 36C25622Q1322 0001.docx | DOCX document | |
| ATTACHMENT E CONTRACTOR CERTIFICATION.docx | DOCX document | |
| ATTACHMENT D PAST PERFORMANCE QUESTIONNAIRE.doc | DOC document | |
| ATTACHMENT B Elevator svcs LA MS 2004-0401 R30.pdf | ||
| ATTACHMENT A Elevator svcs AL FL MS 1968-0005 R70.pdf | ||
| 36C25622Q1322.docx | DOCX document | |
| ATTACHMENT 1 List of Elevators.doc | DOC document | |
| ATTACHMENT 2 Preventive Maintenance Checklist.doc | DOC document | |
| ATTACHMENT G QUALITY ASSURANCE SURVEILLANCE PLAN.docx | DOCX document | |
| ATTACHMENT C LIST OF PAST PERF REF.docx | DOCX document |
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Text version
ATTACHMENT F – NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS
36C25622Q1322
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 .