(05) Exhibit A.pdf
PDF 628 KB Posted
- Attached to
- Mowing Services Sam Houston National Forest-TX Federal contract opportunity
- Solicitation number
- 12444224Q0035
- Issued by
- Department of Agriculture Forest Service
About this file
This document is an Exhibit A: Contractor's Financial Information Sheet, which is part of a solicitation for mowing services for the Sam Houston National Forest located in Texas. The solicitation includes detailed requirements and attachments such as a Statement of Work, maps, and pricing schedules. It is subject to Service Contract Labor Standards. The solicitation number is 12444224Q0035, and it is being issued by the Department of Agriculture Forest Service. Interested contractors must submit offers by the due date and time; late or incomplete offers will not be considered. The Exhibit A document requests general contractor information, financial details, and responses to questions about bankruptcy, judgments, liabilities, and government indebtedness. This information is required as part of the contractor evaluation process for this opportunity.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 12444224Q0035.pdf | ||
| (04) Schedule of Items.xlsx | XLSX spreadsheet | |
| (01) WD-TX.pdf | ||
| (02) SOW.pdf | ||
| (06) Exhibit B.pdf | ||
| (03) Maps.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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