Attachment 6 Financial Institution Reference Sheet.pdf

FINANCIAL INSTITUTION REFERENCE SHEET

Instruc ons to Offeror: Complete and return a reference sheet for each financial ins tu on that you have a business account with. The Offeror is responsible to send this sheet to their banking ins tu on(s) in regards to a determina on of Contractor Responsibility in accordance with FAR 9.104-1, General Standards.

This sheet will be used to evaluate your ability to meet the necessary financial informa on required by this solicita on located at Dobbins ARB, GA. Failure to complete this sheet may render your quote ineligible for award.

NOTE: In lieu of comple on of this Sheet, Offeror may submit a copy of their latest Credit Report, Financial report or Banking Statements. Current or previous year

COMPLETED BY THE OFFEROR

Company’s Name:

Point of Contact (POC) Name:

POC Phone Number:

INSTITUTION’S NAME:

POC Name:

POC Title:

POC Phone Number: Fax Number:

I give permission for the following informa on regarding my account(s) at your ins tu on to be released to representa ves of the 94th Contrac ng Flight, 1538 Atlan c Ave. Bldg. 812, Dobbins ARB, GA 30069-4900.

Print Name / Title Signature Date

COMPLETED BY FINANCIAL INSTITUTION:

Request amount 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 ins tu on:

Credit ra ng with this ins tu on:

I verify that the informa on provided above is current as of

Name / Title Signature