Attach 2 - Financial_HVAC Repair B550_1.pdf

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Repair HVAC Building 838 Bay 1
Solicitation number
FA670325B0004
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This document is a Financial Institution Reference Sheet for solicitation number FA670325B0004 issued by the 94th Contracting Flight at Dobbins Air Reserve Base (ARB) in Georgia. The form requires contractors to provide detailed financial information from their banking institutions, including average monthly balances in checking and savings accounts, current loan and line of credit amounts, payment history, and credit rating. The document is designed to help evaluate a contractor's financial responsibility as part of a solicitation process, with sections to be completed by both the contractor and the financial institution, authorizing the release of financial account information to contracting representatives.

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FINANCIAL INSTITUTION REFERENCE SHEET

Instructions to Contractor: Please fill out and return 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 solicitation number FA670325B0004, Dobbins ARB, GA.

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 94th Contracting Flight, Dobbins ARB, GA.

Printed Name/Title Signature/Date

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 of NSFs: ____________________________________

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

Attachment 2 FA670325B000420 August 2025

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