Attachment 3 - Financial Institution Reference Sheet.pdf
PDF 311 KB Posted
- Attached to
- Snow and Ice Removal Services Federal contract opportunity
- Solicitation number
- FA465923Q0007
About this file
This document is a financial institution reference sheet template to be filled out by contractors bidding on a solicitation for snow and ice removal services at Grand Forks Air Force Base in North Dakota. The template requests information such as average monthly balances in checking and savings accounts, amounts of any current loans or lines of credit, details on any late payments or non-sufficient funds incidents, and the length of time and credit rating with the financial institution. Contractors are to have each of their financial institutions complete the template and return it directly to the contracting officer at Grand Forks AFB. The related solicitation is for snow and ice removal services, issued by the Department of the Air Force Air Mobility Command, with a solicitation number of FA465923Q0007.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment 1 - Snow_Ice Removal PWS dated 25 Jul 2023.pdf | ||
| Attachment 2 - U.S. Wage Determination 2015-4973 (Rev. 23) dated 6_30_2023.pdf | ||
| Combined Synopsis Solicitation (Snow and Ice Removal).pdf | ||
| FA465923Q0007 Snow Removal Solicitation.pdf | ||
| Attachment 4 - Mission Essential Contractor Services Plan.pdf | ||
| Appendix B to PWS - Snow Removal Map.pdf | ||
| Attachment 5 - Past Performance List of References.pdf |
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Text version
Source Selection Information -- See FAR 2.101 and 3.104 – FOR OFFICIAL USE ONLY
Source Selection Information -- See FAR 2.101 and 3.104 – FOR OFFICIAL USE ONLY
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 institutions in regards to a determination of contractor responsibility as part of the evaluation of soliciting/awarding a new contract for Snow and Ice Removal Services at Grand Forks AFB, ND. The top portion should be completed first, then sent to each financial institution for completion. Please have completed surveys returned directly from the financial institutions to Jeremiah Snedker via email at jeremiah.snedker@us.af.mil
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 319th Contracting Squadron, Grand Forks AFB ND.
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
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