ATTH F NOT OF COMPLIANCE WITH INS.docx

DOCX document 17 KB Posted

Attached to
R602--Lab Courier services, JACC, FL Federal contract opportunity
Solicitation number
36C25620Q0945
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

About this file

This document contains an insurance compliance notification form and information on a federal contract opportunity for laboratory courier services. The form is to be completed by contractors to acknowledge they have read and understand the insurance requirements of the contract and agree to maintain at least the types and amounts of coverage specified. It requires the contractor's name, address, signature of an authorized official and date.

The federal contract opportunity is a presolicitation notice for courier services for the Joint Ambulatory Care Center in Pensacola, Florida issued by the Department of Veterans Affairs Network Contracting Office 16. The opportunity is set aside 100% for Service-Disabled Veteran Owned Small Businesses. The NAICS code is 492110 with a size standard of 1,500 employees. Interested parties must be registered in SAM, VETBIZ and report in accordance with VetBiz regulations. No proposals, quotes or phone calls will be accepted at this time. The solicitation number is 36C25620Q0945 and additional details will be provided in the forthcoming solicitation package.

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Other files for this federal contract opportunity

Other files attached to R602--Lab Courier services, JACC, FL, newest first.
File Type Posted
36C25620Q0945 0001.docx DOCX document
36C25620Q0945.docx DOCX document
ATTH E CONTRACTOR CERTIFICATION.docx DOCX document
ATTH A WD 15-4561 Escambia PCola FL R13.pdf PDF
ATTH C PAST PERFORMANCE QUESTIONNAIRE.docx DOCX document
ATTH B LIST OF PAST PERF REF.docx DOCX document
ATTH D QASP.docx DOCX document

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Text version

ATTACHMENT F – NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS

36C25620Q0945

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 .