Appendix M - Proof of Financial Responsibility.pdf

588 KB Posted

Attached to
Construct AFTP Fence, Louisiana Avenue Bridge
Solicitation number
FA481924R0017
Issued by

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This document is a General Financial Information form that is part of a federal contract opportunity. The form requests information to aid the government in determining the financial responsibility of the offeror, including details on the offeror's Central Contractor Registration, point of contact information, parent company information, and financial institution details. The offeror is also required to indicate whether they have the necessary equipment to perform the contract. This form appears to be an attachment to the larger solicitation for the "Construct AFTP Fence, Louisiana Avenue Bridge" requirement at Tyndall AFB, FL. The solicitation is being issued by the Department of the Air Force's Air Combat Command and seeks construction services related to an anti-terrorism force protection fence project.

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GENERAL FINANCIAL INFORMATION

The following information is requested to aid the Government in determining your financial responsibility. If your answer to any question is “Not Applicable” indicate as such.

1. Central Contractor Registration Information:

a) Date Enrolled:__________________________________________________________________

b) Expiration Date:________________________________________________________________

c) DUNS:________________________________________________________________________

d) CAGE:________________________________________________________________________

2. Offeror Point of Contact Information:

a) Name:_________________________________________________________________________

b) Position Held:___________________________________________________________________

c) Telephone:_____________________________________________________________________

d) Email:_________________________________________________________________________

3. Company is a separate entity ( ) division ( ). If a division or subsidiary, please provide name of parent company:_______________________________________________________________________

4. Financial Information:

a) Name of Bank:__________________________________________________________________

b) MailingAddress:_________________________________________________________________

c) Point of Contact:________________________________________________________________

d) Work email/telephone:____________________________________________________________

5. Do you have the equipment needed to perform the contract on which you are submitting a proposal or do you have the resources to obtain the equipment? Yes ( ) No ( )

Typed Name of Preparer Signature Date

FA4819-21-R-0002

TYNDALL AFB, FL

ATTACHMENT 10

GENERAL FINANCIAL INFORMATION

File details come from the government source that posted it. Updated .