FINANICAL CAPABILITY FORM.pdf
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- Solicitation number
- 697DCK-25-R-00074
About this file
This is a Financial Capability Form that assesses a firm's financial stability and past performance for a construction project at the Anchorage Airport Traffic Control Tower and TRACON facility. The form contains eight key questions focused on determining potential risks and financial responsibility of bidding firms.
The questionnaire requires disclosure of: current or past bankruptcy status within 5 years, any debarment or disqualification from government projects, denied public works contract awards, claims exceeding $50,000 filed against or by the firm regarding architectural work, insurance policy renewal refusals, and any findings of liability for false claims to public agencies. For any "yes" answers, firms must provide detailed explanations on separate pages including relevant dates, case numbers, project names, and claim resolutions. This form appears to be part of the qualification process for solicitation number 697DCK-25-R-00074 issued by the FAA Southwestern Region.
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FINANCIAL ABILITY TO PERFORM THE WORK REQUIRED
1. Is the Firm currently the debtor in a bankruptcy case?
If “yes,” indicated the case number, bankruptcy court, and the date on which the petition was filed.
Case Number Bankruptcy Court Date Filed
2. Was the Firm in bankruptcy at any time during the last five (5) years?
If “yes,” indicated the case number, bankruptcy court, and the date on which the petition was filed.
Case Number Bankruptcy Court Date Filed
□ Yes
3. In the last five (5) years has the Firm, been debarred, disqualified, removed, or otherwise prevented from bidding on, or completing, any government agency or public works project for any reason?
□ No
If “yes,” explain on a separate page. State the name of the organization debarred, the year of the event, the Owner of the project, and the basis for the action.
□ Yes
4. Has the Firm ever been denied an award of a public works contract based on a finding by a public agency that they were not properly qualified?
□ No
If “yes,” on a separate page, identify the year of the event, the entity denied the award, the Owner, the project, and the basis for the finding by the public agency.
□ Yes
5. In the past five (5) years, has any claim in excess of $50,000 been filed or made in court or arbitration against the Firm concerning its architectural work on a project for which they were found at fault?
□ No
If “yes,” on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution). This explanation is not counted toward the page count limitation.
□ Yes
6. In the past five (5) years, the Firm made any claim in excess of $50,000 against a project Owner concerning its architectural work on a project and filed or made that claim in court or arbitration?
□ No
If “yes,” on a separate page, identify the claim by providing the project name, date of the claim, name of the entity (or entities) against whom the claim was filed, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending, or if resolved, a brief description of the resolution). This explanation is not counted toward the page count limitation.
□ Yes
7. In the last five (5) years has any insurance carrier, for any form of insurance, refused to renew an insurance policy for the Firm, based on non-payment or losses?
□ No
If “yes,” on a separate page, give name the insurance carrier, the form of insurance, and the year of the refusal.
□ Yes
8. Has the Firm (or any manager of the Firm if the Firm is not a person) ever been found liable in a civil suit or found guilty in a criminal action for making any false claim or material misrepresentation to any public agency or entity?
□ No
If “yes,” on a separate page, identify who was involved, the name of the public agency, the date of the investigation, and the grounds for the finding.
File details come from the government source that posted it. Updated .