(04) Exhibit-A.pdf
PDF 145 KB Posted
- Solicitation number
- 12444224Q0032
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is an Exhibit A: Contractor's Financial Information Sheet that appears to be part of a federal solicitation or contract. It requests general information about the contractor, including their business type, taxpayer ID, DUNS number, products/services provided, business size, and ownership details. The document also asks whether the contractor has any financial issues such as bankruptcy, judgments, or government debt.
The related federal contract opportunity is for Janitorial Services at the Mena-Oden Ranger District East End Visitors Information Center in the Ouachita National Forest, Arkansas. This is a solicitation for a base plus three option year contract to be awarded by the Department of Agriculture Forest Service.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| (03) Updated Schedule of Items.xlsx | XLSX spreadsheet | |
| (02) Updated SOW.pdf | ||
| 12444224Q0032 P0001.pdf | ||
| Site Visit Information.pdf | ||
| Janitorial Services for Mena RD East End Visitors Center Q and A.pdf | ||
| Map of East End VIS.pdf | ||
| SF1449.pdf | ||
| (05) Exhibit-B.pdf | ||
| LIst of Sustainable Products.pdf | ||
| (01) WD Polk County AR.pdf | ||
| (02) SOW.pdf | ||
| (03) Schedule of Items.xlsx | XLSX spreadsheet |
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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.
File details come from the government source that posted it. Updated .