4 - Financial Institution Information Sheet.pdf
PDF 127 KB Posted
- Attached to
- Sports Officials Services Federal contract opportunity
- Solicitation number
- FA452820Q0008
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 1 - PWS Sports Officials 2 June 2020.pdf | ||
| Solicitation Amendment FA452820Q00080001 SF 30.pdf | ||
| 1.1 PWS Appendix 1 Number of Officials Estimates 2020.pdf | ||
| 3 - Past Performance Information Form.pdf | ||
| Solicitation - FA452820Q0008.pdf | ||
| 1 - PWS Sports Officials 2020 Final.pdf | ||
| 1.2 PWS Appendix 2 Minot AFB Sports By-Laws 2020.pdf | ||
| 1.3 PWS Appendix 3 Sports Calendar FY21.pdf | ||
| 2 - WD 2015-5383 Rev 10.pdf |
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Text version
FA452820Q0008
Attachment 4
FINANCIAL INSTITUTION INFORMATION FORM
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 title: ______________________________________________________________________
POC email address: _______________________________________________________________
POC phone number: ______________________ fax number: __________________________
I give permission for the following information regarding my account/s at your institution to be released to representatives of the 5th Contracting Squadron, Minot AFB, North Dakota.
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
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