Attachment 5 Financial Resp.pdf

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Attached to
FA452824R0011 - SABER IDIQ Minot AFB
Solicitation number
FA452824R0011
Issued by

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This document is Attachment 5 - Financial Institution Reference Sheet, which is part of the solicitation FA452824R0011 for the Simplified Acquisition of Base Engineer Requirement (SABER) indefinite delivery, indefinite quantity (IDIQ) contract for construction, sustainment, restoration, and modernization projects at Minot Air Force Base in North Dakota.

The attachment instructs the contractor to include a financial institution reference sheet for each of their business accounts as part of their proposal. This sheet may be sent to the referenced banking institutions to help determine the contractor's responsibility as part of the evaluation for award. The attachment provides a template for the contractor to fill out, including their company information and permission for the financial institution to release account details. The financial institution is then expected to provide information on the contractor's average monthly balances, loan amounts, payment history, and credit rating with that institution. This information will be used to assess the contractor's financial capability as part of the responsibility determination during the solicitation evaluation process.

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Text version

FA4528-24-R-0011

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’S NAME: __________________________________________________________

Point of Contact (POC) Name: ___________________________________________________

POC Phone Number: __________________________________________________________

INSTITUTION NAME: __________________________________________________________

POC name: __________________________________________________________________

POC title: ____________________________________________________________________

POC phone number: ______________________ fax number: ___________________________

Account #_______________________________

I give permission for the following information regarding my account/s at your institution to be released to representatives of the 5th Contracting Squadron, Minot AFB, North Dakota.

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 .