Attachment 5 - Financial Reference Sheet.docx
DOCX document 26 KB Posted
- Attached to
- Install Fire Suppression System Bldg. 90029 Federal contract opportunity
- Solicitation number
- FA441721R0001
About this file
This document includes an attachment requesting financial reference information from contractors and a related federal contract opportunity notice. The attachment is a template for contractors to provide banking references to be contacted as part of a responsibility determination for the federal contract opportunity. The related opportunity is a solicitation from the Department of the Air Force Special Operations Command to furnish all labor, equipment, and materials necessary to perform work to install a fire suppression system in Building 90029 at Hurlburt Field, Florida. The project includes removing and replacing an existing fire suppression foam system, replacing fire pumps, modifying fire alarm and mass notification systems, and installing new power distribution to support the new fire pumps. Responses are due by the date specified in the solicitation.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Corrected 7 Dec 20 - Questions and Answers - Solicitation FA441721R0001.pdf | ||
| Questions and Answers - Solicitation FA441721R0001.pdf | ||
| Solicitation Amendment FA441721R00010001 SF 30.pdf | ||
| Site Visit Attendance Sheet - Redacted.pdf | ||
| Attachment 6 - 50 Division Construction Cost Est Wksht.xls | XLS spreadsheet | |
| Solicitation - FA441721R0001 - Install Fire Sup Sys Bldg 90029.pdf | ||
| Attachment 4 - PPQ.docx | DOCX document | |
| Attachment 3 - Wage Determination FL20190217.pdf | ||
| Attachment 2 - Drawings.pdf | ||
| Attachment 1 - Specifications.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTACHMENT 5
FA441721R0001
Financial Reference Worksheet
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’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 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 |
File details come from the government source that posted it. Updated .