EXHIBIT E SURETY FORM.docx
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- Attached to
- Z2DA--520-21-1-7032-0001 - Project 520-22-125 Replace Nurse Call System (VA-21-00015374)
- Solicitation number
- 36C25621R0053
About this file
This document includes an exhibit surety form and details of a related federal contract opportunity. The contract opportunity is a solicitation to replace the nurse call system at the Gulf Coast Veterans Health Care System in Biloxi, Mississippi. The project cost range is between $500,000 and $1,000,000. The solicitation will be issued as a 100% set-aside for service-disabled veteran-owned small businesses. Interested offerors must check the SAM website for the request for proposals and any amendments, with the proposal due date scheduled for March 1, 2021 and anticipated contract award by April 2021. Offerors must meet SDVOSB eligibility requirements and subcontracting limitations.
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 520-22-125 Replace Nurse Call System, Biloxi 36C25621R0053
EXHIBIT E
SURETY FORM
OFFEROR INSTRUCTIONS: To be completed by Surety and SUBMITTED BY OFFEROR AS A PART OF THE TECHNICAL PROPOSAL PACKAGE.
Contractor Name:
Address:
Telephone: Email:
Please complete below and return no later than:
Surety Name:
Surety Address:
| POC: | Title: | |
| Telephone: | Email: |
How long have you provided bonding for the above contractor? YEARS What is the contractor’s rating?
| Bonding Limit for a single project? | $ |
| Aggregate amount? | $ |
Have you ever had to complete a project for the contractor? [ ] YES [ ] NO Has liability insurance ever been refused? [ ] YES [ ] NO Have there been complaints of non-payment by subcontractor/suppliers? [ ] YES [ ] NO Has the surety had to pay subcontractors/suppliers? [ ] YES [ ] NO
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