Attach 2 FINANCIAL INSTITUTION REFERENCE SHEET.pdf
PDF 167 KB Posted
- Attached to
- Integrated Solid Waste Refuse and Recycling
- Solicitation number
- FA670326Q0006
About this file
This is a Financial Institution Reference Sheet template for solicitation FA670326Q0006, Integrated Solid Waste Management at Dobbins ARB, GA, issued by the 94th Contracting Flight.
The document requires contractors to submit one reference sheet for each business financial institution with which they maintain an account. The contractor section requests company name, point of contact information, institution name, institution POC details, and a signed authorization for the government to contact the financial institution. The financial institution section requires banks to provide account information in range format, including average monthly checking and savings balances, current loan amounts, lines of credit, any history of late payments or NSFs, duration of the banking relationship, and the institution's credit rating assessment. This form is used as part of the contractor responsibility evaluation process for the solicitation and must be completed and returned by the contractor with their proposal.
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Attach 2 July 23 2026 FA670326Q0006
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 FA670326Q- 0006, Integrated Solid Waste Management, 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
File details come from the government source that posted it. Updated .