B08_Attachment_7_Payment_Bond_SF25A-16d.pdf
PDF 730 KB Posted
- Attached to
- CERC Phase 2 A3 Bldg Stabilization Federal contract opportunity
- Solicitation number
- 140G0124R0022
About this file
This document is a Standard Form 25A Payment Bond for a federal contract opportunity. The key details are:
The principal, sureties, and contract details are provided, including the contract number, contract date, and penal sum of the bond. The bond is for the protection of persons supplying labor and material under 40 USC Chapter 31, Subchapter III, Bonds. The principal and sureties are jointly and severally bound to the U.S. Government for the penal sum. The obligation is void if the principal promptly pays all persons having a direct relationship with the principal or a subcontractor for furnishing labor, material, or both in the prosecution of the contract work.
The related federal contract opportunity is for the U.S. Geological Survey Columbia Environmental Research Center (CERC) to stabilize the southeast, southwest, and northwest corners of their A3 main building to correct and prevent further settling. The scope includes adding helical piles, replacing basement concrete, and restoring affected site areas. The contract value is estimated between $250,000 and $500,000. The solicitation (140G0124R0022) will be issued around 7/22/2024 with quotes due around 8/21/2024. This is a total small business set-aside with a NAICS code of 238190 and size standard of $19 million.
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Text version
Corporate Seal
LIABILITY LIMITNAME &
ADDRESS
NAME(S) &
TITLE(S)
(Typed)
SU
R
ET
Y
A
PAYMENT BOND
(See instructions on reverse)
DATE BOND EXECUTED (Must be same or later than date of contract)
PRINCIPAL (Legal name and business address) TYPE OF ORGANIZATION ("X" one)
STATE OF INCORPORATION
MILLION(S)
CONTRACT DATE CONTRACT NUMBER
THOUSAND(S) HUNDRED(S) CENTS
PENAL SUM OF BONDSURETY(IES) (Name(s) and business address(es))
OBLIGATION:
CONDITIONS:
WITNESS:
We, the Principal and Surety(ies), are firmly bound to the United States of America (hereinafter called the Government) in the above penal sum. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally. However, where the Sureties are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum "jointly and severally" as well as "severally" only for the purpose of allowing a joint action or actions against any or all of us. For all other purposes, each Surety binds itself, jointly and severally with the Principal, for the payment of the sum shown opposite the name of the Surety. If no limit is indicated, the limit of liability is the full amount of the penal sum.
The above obligation is void if the Principal promptly makes payment to all persons having a direct relationship with the Principal or a subcontractor of the Principal for furnishing labor, material or both in the prosecution of the work provided for in the contract identified above, and any authorized modifications of the contract that subsequently are made. Notice of those modifications to the Surety(ies) are waived.
The Principal and Surety(ies) executed this payment bond and affixed their seals on the above date.
PRINCIPAL
INDIVIDUAL SURETY(IES)
CORPORATE SURETY(IES)
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0045. We estimate that it will take 1 hour to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.
OMB Control Number: 9000-0045 Expiration Date: 8/31/2022
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
SIGNATURE(S)
NAME(S)
(Typed)
SIGNATURE(S)
AUTHORIZED FOR LOCAL REPRODUCTION
Previous edition is NOT usable
1.
(Seal)
(Seal)
2.
(Seal)
(Seal)
3.
2.
2.
2.
2.
2.
3.
(Seal)
1.
1.
1.
1.
1.
STATE OF INCORPORATION
Corporate Seal
STANDARD FORM 25A (REV. 8/2016)
Prescribed by GSA-FAR (48 CFR) 53.2228(c)
JOINT VENTURE
OTHER (Specify)
PARTNERSHIPINDIVIDUAL
CORPORATION
Corporate Seal
Corporate Seal
Corporate Seal
Corporate Seal
Corporate Seal
LIABILITY LIMIT
STANDARD FORM 25A (REV. 8/2016) BACK
CORPORATE SURETY(IES) (Continued)
SU
R
ET
B
SU
R
ET
C
ET
D
ET
Y
E
SU
R
ET
Y F
SU
R
ET
Y
G
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
SIGNATURE(S)
NAME &
ADDRESS
2.
1.
1.
1.
1.
1.
1.
1.
1.
1.
1.
1.
1.
STATE OF INCORPORATION LIABILITY LIMIT
2.
2.
LIABILITY LIMIT
2.
LIABILITY LIMIT
2.
2.
STATE OF INCORPORATION
LIABILITY LIMIT
STATE OF INCORPORATION
2.
2.
2.
STATE OF INCORPORATION
LIABILITY LIMIT
STATE OF INCORPORATION
2.
2.
2.
STATE OF INCORPORATION
INSTRUCTIONS
1. This form, for the protection of persons supplying labor and material, is used when a payment bond is required under 40 USC Chapter 31, Subchapter III, Bonds. Any deviation from this form will require the written approval of the Administrator of General Services.
2. Insert the full legal name and business address of the Principal in the space designated "Principal" on the face of the form. An authorized person shall sign the bond. Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not a member of the firm, partnership, or joint venture, or an officer of the corporation involved.
3. (a) Corporations executing the bond as sureties must appear on the Department of the Treasury's list of approved sureties and must act within the limitations listed therein. The value put into the LIABILITY LIMIT block is the penal sum (i.e., the face value) of the bond, unless a co-surety arrangement is proposed.
(b) When multiple corporate sureties are involved, their names and addresses shall appear in the spaces (Surety A, Surety B, etc.) headed "CORPORATE SURETY(IES)." In the space designated "SURETY(IES)" on the face of the form, insert only the letter identifier corresponding to each of the sureties. Moreover, when co-surety arrangements exist, the parties may allocate their respective limitations of liability under the bonds, provided that the sum total of their liability equals 100% of the bond penal sum.
(c) When individual sureties are involved, a completed Affidavit of Individual Surety (Standard Form 28) for each individual surety shall accompany the bond.
The Government may require the surety to furnish additional substantiating information concerning its financial capability.
4. Corporations executing the bond shall affix their corporate seals. Individuals shall execute the bond opposite the words "Corporate Seal", and shall affix an adhesive seal if executed in Maine, New Hampshire, or any other jurisdiction requiring adhesive seals.
5. Type the name and title of each person signing this bond in the space provided.
LIABILITY LIMIT
NAME &
ADDRESS
NAME(S) &
TITLE(S)
(Typed)
SURETY A
PAYMENT BOND
(See instructions on reverse) DATE BOND EXECUTED (Must be same or later than date of contract) PRINCIPAL (Legal name and business address) TYPE OF ORGANIZATION ("X" one)
STATE OF INCORPORATION
MILLION(S)
CONTRACT DATE
CONTRACT NUMBER
THOUSAND(S)
HUNDRED(S)
CENTS
PENAL SUM OF BOND
SURETY(IES) (Name(s) and business address(es))
OBLIGATION:
CONDITIONS:
WITNESS:
We, the Principal and Surety(ies), are firmly bound to the United States of America (hereinafter called the Government) in the above penal sum. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally. However, where the Sureties are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum "jointly and severally" as well as "severally" only for the purpose of allowing a joint action or actions against any or all of us. For all other purposes, each Surety binds itself, jointly and severally with the Principal, for the payment of the sum shown opposite the name of the Surety. If no limit is indicated, the limit of liability is the full amount of the penal sum.
The above obligation is void if the Principal promptly makes payment to all persons having a direct relationship with the Principal or a subcontractor of the Principal for furnishing labor, material or both in the prosecution of the work provided for in the contract identified above, and any authorized modifications of the contract that subsequently are made. Notice of those modifications to the Surety(ies) are waived.
The Principal and Surety(ies) executed this payment bond and affixed their seals on the above date.
PRINCIPAL
INDIVIDUAL SURETY(IES)
CORPORATE SURETY(IES)
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0045. We estimate that it will take 1 hour to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.
OMB Control Number: 9000-0045 Expiration Date: 8/31/2022
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
SIGNATURE(S)
NAME(S)
(Typed)
SIGNATURE(S)
AUTHORIZED FOR LOCAL REPRODUCTION
Previous edition is NOT usable 1.
(Seal) (Seal) 2.
(Seal) (Seal) 3.
2.
2.
2.
2.
2.
3.
(Seal) 1.
1.
1.
1.
1.
STATE OF INCORPORATION
Corporate Seal
STANDARD FORM 25A (REV. 8/2016)
Prescribed by GSA-FAR (48 CFR) 53.2228(c) Corporate Seal Corporate Seal Corporate Seal Corporate Seal Corporate Seal Corporate Seal
LIABILITY LIMIT
STANDARD FORM 25A (REV. 8/2016) BACK
CORPORATE SURETY(IES) (Continued)
SURETY B
SURETY C
SURETY D
SURETY E
SURETY F
SURETY G
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
NAME &
ADDRESS
SIGNATURE(S)
NAME(S) &
TITLE(S)
(Typed)
SIGNATURE(S)
NAME &
ADDRESS
2.
1.
1.
1.
1.
1.
1.
1.
1.
1.
1.
1.
1.
STATE OF INCORPORATION
LIABILITY LIMIT
2.
2.
LIABILITY LIMIT
2.
LIABILITY LIMIT
2.
2.
STATE OF INCORPORATION
LIABILITY LIMIT
STATE OF INCORPORATION
2.
2.
2.
STATE OF INCORPORATION
LIABILITY LIMIT
STATE OF INCORPORATION
2.
2.
2.
STATE OF INCORPORATION
INSTRUCTIONS
1. This form, for the protection of persons supplying labor and material, is used when a payment bond is required under 40 USC Chapter 31, Subchapter III, Bonds. Any deviation from this form will require the written approval of the Administrator of General Services.
2. Insert the full legal name and business address of the Principal in the space designated "Principal" on the face of the form. An authorized person shall sign the bond. Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not a member of the firm, partnership, or joint venture, or an officer of the corporation involved.
3. (a) Corporations executing the bond as sureties must appear on the Department of the Treasury's list of approved sureties and must act within the limitations listed therein. The value put into the LIABILITY LIMIT block is the penal sum (i.e., the face value) of the bond, unless a co-surety arrangement is proposed.
(b) When multiple corporate sureties are involved, their names and addresses shall appear in the spaces (Surety A, Surety B, etc.) headed "CORPORATE SURETY(IES)." In the space designated "SURETY(IES)" on the face of the form, insert only the letter identifier corresponding to each of the sureties. Moreover, when co-surety arrangements exist, the parties may allocate their respective limitations of liability under the bonds, provided that the sum total of their liability equals 100% of the bond penal sum.
(c) When individual sureties are involved, a completed Affidavit of Individual Surety (Standard Form 28) for each individual surety shall accompany the bond.
The Government may require the surety to furnish additional substantiating information concerning its financial capability.
4. Corporations executing the bond shall affix their corporate seals. Individuals shall execute the bond opposite the words "Corporate Seal", and shall affix an adhesive seal if executed in Maine, New Hampshire, or any other jurisdiction requiring adhesive seals.
5. Type the name and title of each person signing this bond in the space provided.
8.2.0.3062.1.452232.445150 Standard Form 25A - Payment Bond
| PRINCIPAL (Legal name and business address): |
| SURETY(IES) (Name(s) and business address(es): |
| STATE OF INCORPORATION: |
| CONTRACT NUMBER: |
| CONTRACT DATE. Enter 2 digit month, 2 digit day and 4 digit year.: |
| DATE BOND EXECUTED (Must be same or later than date of contract). Enter 2 digit month, 2 digit day and 4 digit year.: |
| PENAL SUM OF BOND. MILLION(S): |
| PENAL SUM OF BOND. THOUSAND(S): |
| PENAL SUM OF BOND. HUNDRED(S): |
| PENAL SUM OF BOND. CENTS: |
| PRINCIPAL. NAME(S) & TITLE(S) (Typed). 1.: |
| INDIVIDUAL SURETY(IES). NAME(S) |
(Typed). 1.:
| CORPORATE SURETY(IES). SURETY A. STATE OF INCOME.: |
| CORPORATE SURETY(IES). SURETY A. NAME AND ADDRESS.: |
| INDIVIDUAL SURETY(IES). NAME(S) |
(Typed). 2.:
| PRINCIPAL. NAME(S) & TITLE(S) (Typed). 2. : |
| PRINCIPAL. NAME(S) & TITLE(S) (Typed). 3. : |
| CORPORATE SURETY(IES). SURETY A. NAME(S) & TITLE(S) (Typed). 1.: |
| CORPORATE SURETY(IES). SURETY A. NAME(S) & TITLE(S) (Typed). 2. : |
| CORPORATE SURETY(IES). SURETY A. LIABILITY LIMIT $.: |
| : |
| SIGNATURE. THIS IS A PROTECTED FIELD: |
| If Other was selected, specify here. : |
| CORPORATE SURETY(IES) (Continued). SURETY C. NAME AND ADDRESS.: |
| CORPORATE SURETY(IES) (Continued). SURETY C. STATE OF INCOME.: |
| CORPORATE SURETY(IES) (Continued). SURETY C. LIABILITY LIMIT $.: |
| CORPORATE SURETY(IES) (Continued). SURETY C. NAME(S) & TITLE(S) (Typed). 1. : |
| CORPORATE SURETY(IES) (Continued). SURETY D. NAME AND ADDRESS.: |
| CORPORATE SURETY(IES) (Continued). SURETY E. NAME AND ADDRESS.: |
| CORPORATE SURETY(IES) (Continued). SURETY E. STATE OF INCOME.: |
| CORPORATE SURETY(IES) (Continued). SURETY E. LIABILITY LIMIT $.: |
| CORPORATE SURETY(IES) (Continued). SURETY E. NAME(S) & TITLE(S) (Typed). 2. : |
| CORPORATE SURETY(IES) (Continued). SURETY E. NAME(S) & TITLE(S) (Typed). 1. : |
| CORPORATE SURETY(IES) (Continued). SURETY F. NAME AND ADDRESS.: |
| CORPORATE SURETY(IES) (Continued). SURETY F. STATE OF INCOME.: |
| CORPORATE SURETY(IES) (Continued). SURETY F. LIABILITY LIMIT $.: |
| CORPORATE SURETY(IES) (Continued). SURETY F. NAME(S) & TITLE(S) (Typed). 2. : |
| CORPORATE SURETY(IES) (Continued). SURETY G. NAME AND ADDRESS.: |
| CORPORATE SURETY(IES) (Continued). SURETY G. STATE OF INCOME.: |
| CORPORATE SURETY(IES) (Continued). SURETY G. LIABILITY LIMIT $.: |
| CORPORATE SURETY(IES) (Continued). SURETY G. NAME(S) & TITLE(S) (Typed). 1. : |
| CORPORATE SURETY(IES) (Continued). SURETY G. NAME(S) & TITLE(S) (Typed). 2. : |
| CORPORATE SURETY(IES) (Continued). SURETY F. NAME(S) & TITLE(S) (Typed). 1. : |
| CORPORATE SURETY(IES) (Continued). SURETY D. LIABILITY LIMIT $.: |
| CORPORATE SURETY(IES) (Continued). SURETY D. STATE OF INCOME.: |
| CORPORATE SURETY(IES) (Continued). SURETY D. NAME(S) & TITLE(S) (Typed). 2. : |
| CORPORATE SURETY(IES) (Continued). SURETY D. NAME(S) & TITLE(S) (Typed). 1. : |
| CORPORATE SURETY(IES) (Continued). SURETY C. NAME(S) & TITLE(S) (Typed). 2. : |
| CORPORATE SURETY(IES) (Continued). SURETY B. NAME(S) & TITLE(S) (Typed). 2. : |
| CORPORATE SURETY(IES) (Continued). SURETY B. NAME(S) & TITLE(S) (Typed). 1.: |
| CORPORATE SURETY(IES) (Continued). SURETY B. LIABILITY LIMIT $.: |
| CORPORATE SURETY(IES) (Continued). SURETY B. STATE OF INCOME.: |
| CORPORATE SURETY(IES) (Continued). SURETY B. NAME AND ADDRESS.: |
File details come from the government source that posted it. Updated .