Attachment G - Financial Questionnaire.pdf

FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104

Indefinite Delivery Indefinite Quantity - Job Order Contract (JOC)

15F06721R0000156

ATTACHMENT G

FINANCIAL QUESTIONNAIRE

OFFEROR INSTRUCTIONS: Please complete below and return as per instructions no later than:

TBD.

FINANCIAL INSTITUTION INSTRUCTIONS: The Federal Bureau of Investigation is considering the firm listed below for award of a contract. In order to be responsive to FBI’s needs, it is requested that you complete this questionnaire and place it in a sealed envelope showing return address of the financial institution and forward it to the above-mentioned firm no later TBD or you may email as an attachment to Dennis Alber at dgalber@fbi.gov and Andre Wilson at alwilson6@fbi.gov. Your comments are considered Source Selection Sensitive; therefore, you are advised that the Federal Acquisition

Regulation (15.506) prohibits the release of the names of individuals providing reference information about Offeror’s financial status.

Prospective Contractor for which information is being requested:

Firm Name:

Address:

Point of Contact:

Phone Number:

Name & Signature of the Person Authorized to request financial information:

Please complete below and return as per instructions no later than:

Banking Institution:

Account number: Type of account:_ Average balance:_

Do they have a Line of Credit [ ] Yes [ ] No

What is their limitation: Unused Balance:

Relationship with the bank: [ ] Outstanding [ ] Satisfactory [ ] Other:

How long have they been a client:

What is their most recent credit rating:

Date of most recent credit rating:

Credit rating prepared by:

Signature of Provider:

Title: Date:

mailto:dgalber@fbi.gov mailto:alwilson6@fbi.gov