Attachment 4 Contractor Determination of Responsibility.doc

DOC document 53 KB Posted

Attached to
Grand Jury Court Reporting Services for the United States Attorney's Office (USAO) Northern District of Florida, Tallahassee, Florida
Solicitation number
15JA05-20-R-00000063
Issued by

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Solicitation 15JA05-20-R-00000063.pdf PDF
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Attachment 4

SEQ CHAPTER \h \r 1CONTRACTOR DETERMINATION OF RESPONSIBILITY

(FINANCIAL INFORMATION)

TO BE COMPLETED BY CONTRACTOR

Solicitation Information: Offeror:

Date:

Solicitation: 15JA05-20-R-00000063 USAO- Northern District of Florida

Requirement: Grand Jury Court Reporting Services

Contract Amount: Estimated Value $ (WITHOUT 6 MONTH $ VALUE) Financial Reference Contacted:

Financial Institution Name & Address:

Financial Institution Phone:

Financial Institution Contact:

Name/ Title/ Email Address (all mandatory information):

TO BE COMPLETED BY FINANCIAL INSTITUTION:

Questions:

1. When was the account opened? _______________________________________

2. How is the account maintained?

(Excellent Fair Poor)

3. What is the average monthly balance?

(High

Medium Low)

4. Number of figures of balance (Example: If the company has $1,000.00, the number of figures would be a 4). (7 6 5 4 3 2 1)

5. Any account overdrafts? (Yes) (No)

6. Has offeror ever filed for bankruptcy? (Yes) (No)

7. Is the credit standing sufficient to obtain loans from your bank? (Yes) (No)

8. Comments/Further Explanations of Items Above: ____________________________________________________________________________________________________________________________________________________________

SOLICITATION 15JA05-20-R-000000063 NORTHERN DISTRICT OF FLORIDA

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