ATTH G NOT OF COMPLIANCE WITH INS.docx
DOCX document 16 KB Posted
- Attached to
- S209--Entrance mats Federal contract opportunity
- Solicitation number
- 36C25620Q0861
About this file
This document contains an attachment and federal contract opportunity notice. The attachment is a notification of compliance with insurance requirements template for contractors to acknowledge they have read and understand insurance stipulations in the contract. The related federal contract opportunity is a presolicitation notice for entrance mat services at Gulf Coast Veterans Health Care Systems facilities. The Department of Veterans Affairs Network Contracting Office 16 seeks service-disabled veteran-owned small businesses to provide these services via solicitation number 36C25620Q0861, which will be a 100% set-aside. The solicitation utilizes NAICS code 812332 with a $41.5 million business size standard. Interested parties must register in SAM, VetBiz, and Vet 4212 systems to be considered for award. No proposals are being accepted now; the full solicitation package will be available later.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25620Q0861 0001.docx | DOCX document | |
| ATTH B WD 15-4605 Mobile AL Rev 9.pdf | ||
| 36C25620Q0861.docx | DOCX document | |
| ATTH D PAST PERFORMANCE QUESTIONNAIRE.docx | DOCX document | |
| ATTH E QASP.docx | DOCX document | |
| ATTH F CONTRACTOR CERTIFICATION.docx | DOCX document | |
| ATTH C LIST OF PAST PERF REF.docx | DOCX document | |
| ATTH A WD 15-5147 Harrison MS Rev 10.pdf |
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Text version
ATTACHMENT G – NOTIFICATION OF COMPLIANCE WITH INSURANCE REQUIREMENTS
36C25620Q0861
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):________________________________________________________
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