(04) Exhibit-A.pdf
PDF 145 KB Posted
- Attached to
- Janitorial Services for Mena RD Wolf Pen Gap Trail Complex Federal contract opportunity
- Solicitation number
- 12444224Q0034
- 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 collect financial details from prospective contractors for a federal contract opportunity.
The form requests general information about the contractor, including their legal name, business structure, taxpayer ID, contact details, and the type of products or services they provide. It also asks about the contractor's financial status, such as whether they have ever filed for bankruptcy, have any outstanding judgments or liens, or are delinquent on any federal debts. Additionally, the form collects information on the contractor's ownership structure, including the names and titles of partners, principals, and others.
The related federal contract opportunity is a solicitation for Janitorial Services at the Mena-Oden Ranger District Wolf Pen Gap Trail Complex within the Ouachita National Forest in Arkansas. The contract will be a base period with three option years.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 12444224Q0034 P0001.pdf | ||
| (02) Updated SOW.pdf | ||
| (03) Updated Schedule of Items.xlsx | XLSX spreadsheet | |
| Site Visit Information Wolf Pen Gap location correction.pdf | ||
| Site Visit Information.pdf | ||
| Janitorial Services for Mena RD Wolf Pen Gap Q and A.pdf | ||
| wolf pen gap map 30NOV22.pdf | ||
| SF1449.pdf | ||
| (02) SOW.pdf | ||
| (05) Exhibit-B.pdf | ||
| LIst of Sustainable Products.pdf | ||
| (01) WD Polk County AR.pdf | ||
| (03) Schedule of Items.xlsx | XLSX spreadsheet |
Show all 13
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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 .