Attachment 10 - Financial Information Request.pdf
PDF 166 KB Posted
- Attached to
- Repair Dorm B4323 Federal contract opportunity
- Solicitation number
- FA4608-21-R-0004
About this file
This solicitation requests proposals for repair work on dormitory building 4323 at Barksdale Air Force Base in Louisiana. The contractor will replace interior finishes in dorm rooms, including wall coverings, flooring, paint, ceilings and doors. The period of performance is 336 calendar days, though offerors may propose an alternative schedule. The anticipated value of the contract is between $5 million and $10 million. A site visit will be held on November 13, 2020, with RSVPs due by November 5. The solicitation is a woman-owned small business set-aside issued by the Department of the Air Force Global Strike Command. Interested offerors should contact the point of contact for any questions or to be added to the site visit list. Funds are not presently available and no award will be made until funding is secured.
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Text version
MEMORANDUM FOR WHOM IT MAY CONCERN
FROM: 2 CONS/PKB
80 I Kenney Ave., Suite 2300 Barksdale AFB, LA 711 I 0
SUBJECT: Financial Information Request and Release Authorization
REFERENCES: (a) Solicitation FA4608-21-R-0004
1. Our office is evaluating ___________________________ _
(NAME OF FIRM)
of
(FIRM'S ADDRESS, INCLUDING CITY, STATE, AND ZIP CODE)
for possible award of referenced contract. In order to proceed, we must verify the contractor's financial capability. The firm has provided your name as their bank reference and granted you release, as indicated below, to provide it to the government.
2. Please complete the attached questionnaire and return it by email to michael.madison.2@us.af.mil and christopher.mitchell.36@us.af.mil at your earliest convenience.
3. All information provided will be FOR OFFICIAL USE ONLY and will not be publicly released. If you need any other information or have any questions, please call SSgt Michael Madison at 318-456-0807 or Christopher Mitchell at 318-456-6739. Thank you very much for your assistance.
Attachment Financial Information Sheet
POIRIER.MARL Digitallysignedby
POIRIER.MARLA.J.1101737590
A.J .1101737590 Date: 2020.09.2913:38:03-0S'00'
MARLA J. POIRIER
Contracting Officer
1st Ind, ___________________________ _ (Name of Offeror 's Firm)
TO: ____________________________ _
(Date)
(Name of Financial Institution) (Phone # w/Area Code)
D I hereby authorize the financial institution to release my information as requested.
SIGNATURE:
BY: _____________________________ _
(Print name/title of authorized representative)
RESPONSIBILITY QUESTIONNAIRE - FINANCIAL
FA4608-21-R-0004
REP AIR DORM BLDG 4323
1. Name of Contractor to whom the following information is applicable:
2. Name of Financial Institution:
3. Address of Financial Institution:
4. How long has the firm been a commercial customer of your bank?
5. W_hat is the type of account and its average* balance? (continue on separate sheet if necessary)
□ Checking $ □ Checking $
□ Savings $ □ Savings $
□ CD$ □ CD$
□ Money Market $ □ Money Market $
□ Other $
(SPECIFY TYPE)
6. Does the company maintain a loan balance at the bank? In what amount?
0 YES O NO $
7. Does the company maintain an unsecured line of credit at the bank? In what amount?
0 YES O NO $ ___ _
8. What company's standing with your bank?
D Outstanding D Excellent D Satisfactory
D Other Explain on separate sheet of paper
D Poor D Unsatisfactory
9. COMMENTS: ________________________ _
I certify that the above information is correct and current as of ______________ _
(DATE)
SIGNATURE:
BY:
(Print name/title of authorized representative)
DATE; ------------------------------------
File details come from the government source that posted it. Updated .