Insurance_Requirements.pdf

Notification of Compliance with Contract Insurance Requirements

Whenever the clause 52.228-5, Insurance—Work on a Government Installation, is included in a contract, prime contractors shall be required to either provide copies of insurance certificates or state in writing that the required insurance has been obtained before commencing work on the installation. If the contractor's statement is used in lieu of submission of insurance certificates to the contracting officer, the following Notification of Compliance with Insurance Requirements shall be used for the prime contractor. After completion by the contractor, the Notification of Compliance shall become part of the official contract file.

Contract No:

The undersigned Contractor hereby acknowledges that he/she has read and understands the insurance requirements specified in this contract and hereby provides notification (1) that such insurance shall be maintained in at least the amounts and types as stated in FAR 28.307-2 and during any modifications and/or time extensions granted thereto;

(2) that the required insurance policies shall contain an endorsement to the effect that any cancellation of material changes 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 thirty (30) calendar days after the insurer or contractor gives written notice to the Contracting Officer, whichever period is longer; (3) that _____________ (state) Workers' 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/or time extensions granted thereto; and (4) that a copy of all subcontractors' proofs of required insurance shall be maintained and shall be made available to the Contracting Officer upon request. This agreement shall be a part of subject contract and shall be legally binding and enforceable at law.

INSURANCE COMPANY(S):

Name:

Address:

Policy #:

Telephone #:

CONTRACTOR:

Company Name:

Address:

(Typed Name and Title) (Date)

(Authorized Signature)

Attachment 8