Attachment 5 - Financial Institution Reference Sheet.pdf
PDF 108 KB Posted
- Attached to
- Convert Bldg 91157 from Storage Warehouse to Testing Lab Federal contract opportunity
- Solicitation number
- FA441721B0003
About this file
This document contains an attachment to a federal solicitation requesting references from offerors' financial institutions. The solicitation seeks to convert Building 91157 at Hurlburt Field, Florida from a storage warehouse to a testing laboratory for the Department of the Air Force Special Operations Command. Offerors must include a reference sheet from each financial institution where they hold business accounts, authorizing the institution to provide information about average monthly balances, current loans and lines of credit, payment history, and creditworthiness to the contracting squadron for responsibility determinations. The financial institution reference sheet template requires the institution to provide the requested information upon notification that the offeror is a potential awardee.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| FA441721B0003 - Questions and Answers - Part 2.pdf | ||
| Solicitation Amendment 2 - FA441721B00030002 SF 30.pdf | ||
| Attachment 6 - Specifications - Revised (Addendum 1).pdf | ||
| CE Response - Site Visit Questions.pdf | ||
| Attachment 7 - Drawings - Revised (Addendum 1).pdf | ||
| Addendum 1 - Drawings Changes.pdf | ||
| Addendum 1 - Specs Changes.pdf | ||
| Memo for Record - FA441721B0003 Pre-Proposal Conference_Site Visit - 25 August 2021.pdf | ||
| Site Visit Sign In Sheet - 25 August 2021.pdf | ||
| FA441721B0003 - Questions and Answers - Part 1.pdf | ||
| Solicitation Amendment 1 - FA441721B0003 SF 30.pdf | ||
| Attachment 2 - Drawings.pdf | ||
| Attachment 4 - DBA Wage Determination FL20210217.pdf | ||
| Solicitation - FA441721B0003.pdf | ||
| Attachment 3 - Working Time Analysis.pdf | ||
| Attachment 1 - Specifications.pdf |
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Text version
SOLICITATION NUMBER: _______________
ATTACHMENT 5 FINANCIAL INSTITUTION REFERENCE SHEET
Instructions to Contractor: Include with your proposal 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 award of this solicitation.
TO BE FILLED OUT BY CONTRACTOR:
COMPANY INFORMATION
Company Name: ________________________________________________________________
Point of Contact (POC) Name: ________________________________________________________________
POC Phone Number: ________________________________________________________________
INSTITUTION INFORMATION
Institution Name: ________________________________________________________________
POC Name: ________________________________________________________________
POC Title: ________________________________________________________________
POC Phone Number: ________________________________________________________________
POC Fax Number: ________________________________________________________________
POC Email: ________________________________________________________________
I give permission for the following information regarding my account/s at your institution to be released to representatives of the 1st Special Operations Contracting Squadron, Hurlburt Field, FL.
Name/Title Signature Date
DO NOT HAVE THIS SECTION FILLED OUT. IF YOUR FIRM IS SELECTED AS THE POTENTIAL
AWARDEE, THIS FORM WILL BE SENT TO YOUR BANKING INSTITUTION FOR COMPLETION.
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 or NSF’s? _________________________________________________________
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
| FINANCIAL INSTITUTION REFERENCE SHEET: FA441721B0003 |
| undefined: |
| Point of Contact POC Name 1: |
| Point of Contact POC Name 2: |
| 1: |
| 2: |
| 3: |
| 4: |
| 5: |
| 6: |
| NameTitle: |
| Date: |
| Please give amounts as a range ie low four figures mid six figures etc: |
| Average monthly balance in savings 1: |
| Average monthly balance in savings 2: |
| Average monthly balance in savings 3: |
| Average monthly balance in savings 4: |
| Average monthly balance in savings 5: |
| Average monthly balance in savings 6: |
| undefined_2: |
| NameTitle_2: |
| Date_2: |
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