9 Financial Reference Sheet.docx
DOCX document 17 KB Posted
- Attached to
- Dyess AFB MACC Request for Proposals Federal contract opportunity
- Solicitation number
- FA4661-20-R-0001
About this file
This document contains a financial reference sheet template and details of a federal contract opportunity for construction services at Dyess Air Force Base in Texas. The solicitation seeks proposals for an Indefinite Delivery Indefinite Quantity Multiple Award Construction Contract with an anticipated award date in 2020. Offerors must submit the financial reference sheet with banking references and account information as an attachment to their proposals, which are due by the closing date specified in the solicitation. Proposals will be evaluated based on the criteria outlined in the solicitation. Existing as-built drawings can be requested from the email address provided, and all interested parties should monitor the site for any amendments to documents or changes to the statement of work. The notice also includes answers to questions received during the pre-solicitation phase.
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Text version
FA4661-20-R-0001 Attachment 9
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:
BONDING INSTITUTION NAME:
POC name:
POC title:
POC phone number:
FINANCIAL INSTITUTION NAME:
POC name:
POC title:
POC phone number:
I give permission for the following information regarding my account/s at your institution to be released to representatives of the 7th Contracting Squadron, Dyess AFB, TX.
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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