Attachment 14 - Proof of Financial Responsibility.pdf
PDF 588 KB Posted
- Attached to
- Repair Sprung City Parking Lot on Tyndall AFB
- Solicitation number
- FA481922R0022
About this file
This document contains a general financial information template and details of a related federal contract opportunity for repair work. The financial information template requests company and banking details to aid the government in determining financial responsibility. It asks for Central Contractor Registration information including dates and identification numbers. It also requests the name and contact information of an offeror point of contact and whether the company has necessary equipment or resources to perform the proposed contract.
The related federal contract opportunity is a solicitation to conduct a design-build reconstruction project to demolish, repair and restore a parking area supporting vehicle storage for multiple departments at Tyndall Air Force Base in Florida. The work includes demolishing and repairing the damaged city parking lot. The contracting agency is the Department of the Air Force Air Combat Command.
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Text version
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 .