SF25A-16d (1).docx

Standard Form DOCX document 17 KB Posted

Attached to
Water Service Line Extension, Four Homes Yukon, OK
Solicitation number
246-24-Q-0204
Issued by

About this file

This document is a Payment Bond form (Standard Form 25A) for a federal contract opportunity. The related federal contract opportunity is for a Water Service Line Extension project to serve four homes in Yukon, Oklahoma. The solicitation is issued as Request for Quotes (RFQ) 246-24-Q-0204 under NAICS code 237110 with a size standard of $45.0 million. It is a 100% Indian Owned set-aside. The contractor shall furnish and install a water service line extension with a period of performance of 90 calendar days from the Notice to Proceed. Questions are due by September 9, 2024 and quotes are due by September 16, 2024. The estimated award amount is between $100,000 and $250,000. Quotes will be evaluated on an acceptable/non-acceptable basis, with the lowest reasonable price and technically acceptable quote receiving the award. The Department of Health and Human Services Indian Health Service is the procuring agency.

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Who attaches SF 25A

State Files
Montana 1

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Revised - bid sheet.pdf PDF
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SF24-16d (1).docx DOCX document
ok29 (1).txt TXT text file
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RFQ Construction Clauses-updated May 2024.pdf PDF
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Text version

PAYMENT BOND

(See instructions on reverse)

DATE BOND EXECUTED (Must be same or later than date of contract)
OMB Control Number: 9000-0045 Expiration Date: 8/31/2022

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.

PRINCIPAL (Legal name and business address)
TYPE OF ORGANIZATION ("X" one)
INDIVIDUALPARTNERSHIPJOINT VENTURE CORPORATIONOTHER (Specify)

STATE OF INCORPORATION

SURETY(IES) (Name(s) and business address(es))
PENAL SUM OF BOND
MILLION(S)
THOUSAND(S)
HUNDRED(S)
CENTS
CONTRACT DATE
CONTRACT NUMBER

OBLIGATION:

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.

CONDITIONS:

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.

WITNESS:

The Principal and Surety(ies) executed this payment bond and affixed their seals on the above date.

PRINCIPAL

SIGNATURE(S)

1.

(Seal) 2.

(Seal) 3.

(Seal)

Corporate Seal

NAME(S) & TITLE(S)

(Typed)

1.
2.
3.

INDIVIDUAL SURETY(IES)

SIGNATURE(S)
1.

(Seal) 2.

(Seal)

NAME(S)

(Typed)

1.
2.

CORPORATE SURETY(IES)

SURETY A
NAME & ADDRESS
STATE OF INCORPORATION
LIABILITY LIMIT

Corporate Seal

SIGNATURE(S)
1.
2.

NAME(S) &

TITLE(S)

(Typed)

1.
2.

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is NOT usable

STANDARD FORM 25A (REV. 8/2016)

Prescribed by GSA-FAR (48 CFR) 53.2228(c)

CORPORATE SURETY(IES) (Continued)

SURETY B
NAME & ADDRESS
STATE OF INCORPORATION
LIABILITY LIMIT
SIGNATURE(S)
1.
2.

NAME(S) & TITLE(S)

(Typed)

1.
2.
SURETY C
NAME & ADDRESS
STATE OF INCORPORATION
LIABILITY LIMIT
SIGNATURE(S)
1.
2.

NAME(S) & TITLE(S)

1.
2.
SURETY D
NAME & ADDRESS
STATE OF INCORPORATION
LIABILITY LIMIT
SIGNATURE(S)
1.
2.

NAME(S) & TITLE(S)

1.
2.
SURETY E
NAME & ADDRESS
STATE OF INCORPORATION
LIABILITY LIMIT
SIGNATURE(S)
1.
2.

NAME(S) & TITLE(S)

1.
2.
SURETY F
NAME & ADDRESS
STATE OF INCORPORATION
LIABILITY LIMIT
SIGNATURE(S)
1.
2.

NAME(S) & TITLE(S)

1.
2.
SURETY G
NAME & ADDRESS
STATE OF INCORPORATION
LIABILITY LIMIT
SIGNATURE(S)
1.
2.

NAME(S) & TITLE(S)

1.
2.

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.

STANDARD FORM 25A (REV. 8/2016) BACK

File details come from the government source that posted it. Updated .