(04) Exhibit-A.pdf
PDF 145 KB Posted
- Attached to
- LTM and Boundary Marking - Sam Houston NF Texas Federal contract opportunity
- Solicitation number
- 12444224Q0007
- Issued by
- Department of Agriculture Forest Service
About this file
This document contains an exhibit detailing contractor financial information requirements and a related federal contract opportunity solicitation for boundary marking services. The solicitation from the Department of Agriculture Forest Service is for leave tree and timber sale unit boundary marking on the Sam Houston National Forest in Montgomery County, Texas. Interested offerors must quote by reviewing the requirements package and submitting required documents, including the solicitation, statement of work, maps, contractor financial exhibit, and past performance exhibit by January 19, 2024 at 0900 hours Central Time to the specified email address. The opportunity will require marking boundaries for the Baker Leave Tree and Timber Sale project area as depicted in the associated maps.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 12444224Q0007.pdf | ||
| (01) Wage Determination-TX.pdf | ||
| (02) SOW.pdf | ||
| (03) Maps.pdf | ||
| (05) Exhibit-B.pdf |
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Text version
Exhibit A: CONTRACTOR’S FINANCIAL INFORMATION SHEET
SECTION 1 – GENERAL INFORMATION
1A.NAME 2. TYPE OF ORGANIZATION (CHECK ONE)
A. Sole Proprietorship F. LLC
1B. STREET ADDRESS B. General Partnership
G. Joint Venture C. Limited Partnership H. Non-Profit/Education
1C. CITY 1D. STATE 1E. ZIP/POSTAL D. Corporation I. Other: Specify E. Subchapter S.
3. TAXPAYER ID NUMBER : 4. PHONE NUMBER 5. FAX NUMBER
6. DUNS NUMBER: 7. CELLPHONE NUMBER
8. KIND OF PRODUCT OR SERVICE PROVIDED: 9. EMAIL ADDRESS
10. KIND OF BUSINESS- Specify one block (plus “J” if applicable)
A. LARGE BUSINESS E. EMERGING SMALL
BUSINESS
I. INDIAN SDB
B. SMALL BUSINESS F. VETERAN SMALL BUSINESS J. HUB ZONE - Also
C. SMALL DISADVANTAGED BUSINESS G. SERVICE DISABLED
VETERAN OWNED SMALL
BUSINESS
K. Other: Please Specify
D. WOMAN OWNED SMALL BUSINESS H. INDIAN SMALL BUSINESS
11. OWNERSHIP INFORMATION – PARTNERS – PRINCIPALS - OTHERS
NAME TITLE
13.
14.
15.
16. Questions. If “Yes” to any below, attach detailed information. Yes No A. Have you/your affiliates ever filed for bankruptcy?
B. Do you have any judgments, liens, pending suits?
C. Do you have any contingent liabilities?
D. Have you/your affiliates discontinued business operations with outstanding debts?
SECTION II. GOVERNMENT FINANCIAL AID AND INDEBTEDNESS
If “Yes”, attach detailed information.
Yes No
17. Are you delinquent on any Federal Debt (OMB Circular 129)
18. Do you owe the Government for any contract or other claims?
19. Are you currently receiving Government Financing? (Bonds, Loans, Advanced Payments, Progress Payments, Other)
19a. Are you now in or pending Default on ANY Obligations (i.e. Banks, Financial Institutions, Suppliers, Other)? IF yes please attach detailed information.
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