(04) Exhibit A.pdf
PDF 630 KB Posted
- Attached to
- Davey Crockett Janitorial Services Federal contract opportunity
- Solicitation number
- 12444224Q0053
- Issued by
- Department of Agriculture Forest Service
About this file
This document appears to be the Contractor's Financial Information Sheet, which is Exhibit A of a federal contract opportunity. It requests general information about the contractor, such as name, address, taxpayer ID, and type of organization. It also asks about the contractor's financial history, including any bankruptcy filings, judgments, or outstanding debts. The document requires the contractor to disclose any delinquent federal debts or current government financing. This information is likely required as part of the evaluation process for the associated federal contract opportunity.
The related federal contract opportunity is a Request for Quote (RFQ) for Janitorial Services for the Davey Crockett District Office and Work Center in Texas. The solicitation number is 12444224Q0053, and the services are subject to the Service Contract Labor Standards. The RFQ includes attachments with the wage determination rates, statement of work, and pricing schedule. Offers are due by 08/21/2024 at 9:00 AM ET, and the contracting agency is the Department of Agriculture Forest Service.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| (03) Schedule of Items (corrected).xlsx | XLSX spreadsheet | |
| (01) WD-TX.pdf | ||
| (02) SOW-PWS.pdf | ||
| (03) Schedule of Items.xlsx | XLSX spreadsheet | |
| (05) Exhibit B.pdf | ||
| 12444224Q0053.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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