(04) Exhibit A.pdf
PDF 628 KB Posted
- Attached to
- Upfit 2 Fire Command Vehicles for the NFGT Federal contract opportunity
- Solicitation number
- 12444224Q0021
- Issued by
- Department of Agriculture Forest Service
About this file
This document is a Contractor's Financial Information Sheet, which is a form used to gather financial and business information about a potential contractor. The key details are:
The form requests general business information, including the contractor's name, address, tax ID, contact details, and type of organization (e.g. sole proprietorship, corporation, LLC). It also asks about the contractor's products/services, business size designations (e.g. small business, woman-owned, HUBZone), and ownership details. The form includes questions about the contractor's financial status, including any bankruptcy filings, outstanding judgments/liens, contingent liabilities, or delinquency on federal debts. It also asks if the contractor is currently receiving any government financing or is in default on any obligations.
This form appears to be a standard document used to collect background and financial information about potential contractors bidding on federal contract opportunities. The information provided would allow the government to assess the contractor's responsibility and financial capability to perform the required work.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Schedule of Items (Amended).xlsx | XLSX spreadsheet | |
| 12444224Q0021-0001 (SF30).pdf | ||
| (01) WD-TX.pdf | ||
| 12444224Q0021.pdf | ||
| (02) SOW.pdf | ||
| (03) Schedule of Items.xlsx | XLSX spreadsheet | |
| (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. SAM Unique Entity Identifier: 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.
https://sam.gov/content/duns-uei
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File details come from the government source that posted it. Updated .