18-Form 4-Financial Questionnaire.docx
DOCX document 28 KB Posted
- Attached to
- 3202600107 Mopac Print Shop Upgrades Services
- Solicitation number
- 3202600107
- Issued by
- Travis County, Austin City, Texas
About this file
This is a Financial Questionnaire form for the Texas Workforce Commission (TWC) related to contract opportunity 3202600107 for Mopac Print Shop Upgrades Services. The TWC is soliciting proposals to provide and install an HVAC Energy Recovery Ventilator (ERV), ceiling tiles, flooring tiles, and perform ductwork modifications at the TWC Mopac Building located at 12312 North MoPac Expressway, Austin, Texas. The questionnaire requires respondents to disclose critical financial and operational information to establish contractor qualifications and reliability for project execution.
Respondents must complete five disclosure sections addressing: bankruptcy filings or criteria met within the past five years; current defaults on loan agreements or financial arrangements; any pending sale or acquisition transactions affecting company organization or directors; project failures or incomplete projects within the past five years; and contract terminations for default or convenience within the past five years. Respondents must provide detailed explanations for any affirmative responses, including dates, circumstances, and resolution prospects where applicable. The form allows for supplemental documentation on additional pages as needed to fully address each inquiry.
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Text version
Form 4- FINANCIAL QUESTIONNAIRE 3202600107-Mopac Print Shop Upgrades
Respondent name: ________________________
The Respondent must provide the following information. If more space is needed for the explanation, please attach additional page(s) as necessary:
a. Indicate if your company or any of its subsidiaries filed or met criteria for bankruptcy within the past five years, if so, provide explanation.
b. Indicate if your firm is currently in default on any loan agreement or financial agreement institution, or other entity. If so, specify date(s), details, circumstances, and prospect resolution.
c. Identify if your company is currently for sale or involved in any transaction to expand or become acquired by another business entity. If so, explain the impact both in organization and company director.
d. Indicate if your company has ever failed to complete a project or if a project was ever stopped in the middle of a project within the past five years. If so, why.
e. Indicate if your company has had a contract terminated for default or convenience within the past five years. Yes or No, If yes, provide explanation.
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