2.2.1 Attachment 4 Determination of Finance Responsibility.pdf

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Level II Armed Security Guards for the State of Alabama
Solicitation number
70FBR423R00000026
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U. S. Department of Homeland Security FEMA Region IV, Atlanta, GA 3005 Chamblee Tucker Road Atlanta, GA 30341

DETERMINATION OF FINANCIAL RESPONSIBILITY QUESTIONNAIRE

1. Carefully review the questionnaire of offeror’s responsibility.

2. Banking Information:

Name of Bank: Date:

Phone #:

Name of Bank Representative:

Signature of Representative:

How long has the vendor been a banking customer:

Is there any reason you would not provide this vendor a loan?

[VENDOR COMPLETES BOTTOM ONLY]

I, (Name), (Title) of (Company Name), hereby authorize the release of the above information to the Federal Emergency Management Agency, 3005 Chamblee Tucker Rd, Atlanta, Georgia, 30341.

(Signature)

(Date) www.fema.gov

(To be completed by the Banking Institution) http://www.fema.gov/

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