Attachment 3 Financial Institution Reference Sheet.docx
DOCX document 34 KB Posted
- Attached to
- Repair Base Roads on Grissom Air Reserve Base
- Solicitation number
- FA465425Q0010
About this file
The document is a Financial Institution Reference Sheet for a federal contract opportunity (Solicitation Number FA465425Q0001) related to a construction project at Grissom Air Reserve Base in Indiana. The form requires contractors to provide detailed financial information from their banking institutions, including average account balances, loans, lines of credit, payment history, and credit rating. The reference sheet is part of the contractor responsibility determination process for a project involving road repairs.
The associated federal contract opportunity is for repairing base roads at Grissom Air Reserve Base, with a project value between $25,000 and $100,000. The construction project includes nine sections of work: crack sealant, pavement markings, joint sealing, full depth patches, spall repair, curb repair, sidewalk work, and traffic maintenance. A mandatory site visit is scheduled for 17 June 2025, and potential bidders must complete a DBIDS QR Code process by 16 June 2025. The project is under the Department of the Air Force Reserve Command, with the NAICS code 237310, and is currently unfunded, with no guarantee of award until funds become available.
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Text version
19 JAN 2025
Attachment 9
FA465425B0001
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 FA465425B0001, Project CTGB 162017, Add/Renovate Aircraft Maintenance Shop FAC 453, Grissom Air Reserve Base, IN
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 USAF AFRC 434 CONF/LGC, Grissom ARB, IN.
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 .