4. Financial Reference.docx
DOCX document 17 KB Posted
- Attached to
- Repair WHCA POL Tanks
- Solicitation number
- FA706024R0003
About this file
This document outlines requirements for a federal contract opportunity to repair petroleum, oil, and lubricant tanks for the White House Communications Agency. The project includes removing underground oil-water separators and storage tanks in two buildings, installing new oil-water separators with integral storage and alarms, removing an underground 10,000-gallon diesel tank and replacing it with above-ground tanks, and connecting all tanks and installing two 250-gallon interior oil tanks with spill prevention measures. The acquisition is a small business set-aside between $250,000 and $500,000 requiring a 20% bid bond. The contract will be firm-fixed price awarded by the Department of the Air Force at Joint Base Anacostia Bolling after funds become available, as no award will be made under this solicitation until then. The government reserves the right to cancel the solicitation before or after the closing date without obligation to reimburse offerors for any costs.
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Text version
FA706024R0003
Attachment 4
FINANCIAL INSTITUTION REFERENCE SHEET
Instructions to Contractor: Include with your proposal a reference sheet for each financial institution that you have a business account with. This sheet may be sent to the banking institution/s in regards to a determination of contractor responsibility as part of the evaluation for award of this solicitation.
TO BE FILLED OUT BY CONTRACTOR:
COMPANY’S NAME: __________________________________________________________
Point of Contact (POC) Name: ___________________________________________________ POC Phone Number: __________________________________________________________
INSTITUTION NAME: __________________________________________________________
POC name: __________________________________________________________________ POC email address:____________________________________________________________ POC title: ____________________________________________________________________ POC phone number: ______________________ fax number: ___________________________ Account #_______________________________
I give permission for the following information regarding my account/s at your institution to be released to representatives of the 11th Contracting Squadron, Joint Base Anacostia-Bolling, DC.
| _____________________________________ | _____________________________________ | |
| Name/Title | Signature/Date |
DO NOT HAVE THIS SECTION FILLED OUT. IF YOUR FIRM IS SELECTED AS THE POTENTIAL AWARDEE, THIS FORM WILL BE SENT TO YOUR BANKING INSTITUTION FOR COMPLETION.
TO BE FILLED OUT BY FINANCIAL INSTITUTION:
Please give amounts as a range – i.e. low four figures, mid six figures, etc.
Average monthly balance in checking: ________________ Average monthly balance in savings: _________________ Amount of any current loans: ______________ Amount of any lines of credit: ______________ Any late payments or NSF’s? ______________ How long with this institution: ______________ Credit rating with this institution: ______________
I verify that the information provided above is current as of ____________.
| _____________________________________ | ________________________________ | |
| Name/Title | Signature/Date |
File details come from the government source that posted it. Updated .