2.2.1 Proposal Attachment 6 Determination of Finance Responsibility.pdf
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- Solicitation number
- 70FBR427R00000001
About this file
This is a Determination of Financial Responsibility Questionnaire form issued by the Federal Emergency Management Agency (FEMA), Region IV, located in Atlanta, Georgia. The form is designed to assess the financial capability and creditworthiness of vendors seeking to contract with FEMA.
The questionnaire requires banking institutions to complete the upper section by providing specific information about the vendor's financial standing, including the bank's name, contact information, and the name of the bank representative completing the form. Banks must indicate how long the vendor has maintained an account relationship with them and whether there are any reasons the bank would decline to provide the vendor a loan. The vendor must complete the lower section by authorizing the release of banking information directly to FEMA at the Atlanta office address. This authorization requires the vendor representative to provide their name, title, company name, signature, and date. The form serves as a pre-award responsibility determination tool to verify that potential contractors possess adequate financial resources to perform federal contract obligations.
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Text version
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/
File details come from the government source that posted it. Updated .