ATCH L2 - Financial Questionnaire.docx
DOCX document 23 KB Posted
- Attached to
- ADDITION TO CDC WEST BLDG 90306, CP1024656
- Solicitation number
- FA441723R0009
About this file
This document contains a financial questionnaire attachment for solicitation FA2823-23-R-0009 from the Department of the Air Force Special Operations Command. The financial questionnaire requests information from offerors such as average monthly balances in checking and savings accounts, amounts of any current loans or lines of credit, and credit history with financial institutions. It also includes a form for financial institutions to fill out providing details on account balances and credit ratings if the offeror is selected as the potential awardee. The solicitation is for an addition to CDC West Building 90306 under contract number FA441723R0009. No other details are provided on required products or services.
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Text version
FOR OFFICIAL USE ONLY
SOURCE SELECTION SENSITIVE – SEE FAR 3.104
ATTACHMENT L2
FA2823-23-R-0009
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 title: _________________________________________________________________ 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 Contracting Squadron, Hurlburt Field AFB, FL.
| _____________________________________ | ________________________________ | |
| 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 |
FOR OFFICIAL USE ONLY
SOURCE SELECTION SENSITIVE – SEE FAR 3.104
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