(06) Exhibit-A.pdf
PDF 145 KB Posted
- Solicitation number
- 12444225Q0029
- Issued by
-
Department of Agriculture Forest Service
About this file
The document is a Contractor's Financial Information Sheet, a standard form used to collect comprehensive financial and organizational details about a potential government contractor. Section I captures general business information including organization type (options range from Sole Proprietorship to LLC), business size classification (Large Business, Small Business, Woman-Owned Small Business, etc.), and basic contact details. Section II focuses on the company's financial standing by inquiring about potential financial risks such as past bankruptcies, outstanding debts, government financial obligations, and current financial status. The form requires contractors to disclose any delinquencies, ongoing government financing, or pending defaults on financial obligations, with provisions to attach detailed explanatory documentation for any affirmative responses.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| (03) Schedule of Items.xlsx | XLSX spreadsheet | |
| (02) SOW.pdf | ||
| 12444225Q0029.pdf | ||
| (07) Exhibit-B.pdf | ||
| (04) Mena Office Layout.pdf | ||
| (03) Schedule of Items.xlsx | XLSX spreadsheet | |
| SF1449.pdf | ||
| (01) WD Polk County AR.pdf | ||
| (05) Mena Workcenter Layout.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .