Attachment 9 - Financial Information.pdf

DEPARTMENT OF THE AIR FORCE

2D CONTRACTING SQUADRON (AFGSC)

BARKSDALE AIR FORCE BASE LOUISIANA

13 June 2022

MEMORANDUM FOR WHOM IT MAY CONCERN

FROM: 2 CONS/PKB

801 Kenney Ave. Bldg. 4400 Suite 2301 Barksdale AFB, LA 71110-2438

SUBJECT: Financial Information Request and Release Authorization

REFERENCES: Solicitation FA460822B0006

1. Our office is evaluating ______________________________________(NAME OF FIRM) of

(FIRM’S ADDRESS, INCLUDING CITY, STATE, AND ZIP CODE)

for possible award of referenced contract. In order to proceed, we must verify the contractor’s financial capability. The firm has provided your name as their bank reference and granted you release, as indicated below, to provide it to the government.

2. Please complete the attached questionnaire and return it by email to christopher.mitchell.36@us.af.mil and thomas.hutchins@us.af.mil at your earliest convenience, but no later than 9:15 A.M. (CST) on 22 July, 2022.

3. All information provided will be FOR OFFICIAL USE ONLY and will not be publicly released. If you need any other information or have any questions, please call Christopher Mitchell at 318-456-6739 or TSgt Thomas Hutchins at 318-456-4007. Thank you very much for your assistance.

CHRISTOPHER L. MITCHELL, GS-13, DAF

Contracting Officer

FA460822B0006

Attachment 9

RESPONSIBILITY QUESTIONNAIRE

- FINANCIAL FA460822B0006

1. Name of Contractor to whom the following information is applicable:

2. Name of Financial Institution:

3. Address of Financial Institution:

4. How long has the firm been a commercial customer of your bank?

5. What is the type of account and its average* balance? (continue on separate sheet if necessary)

Checking $ Checking $ Savings $ Savings $

CD $ CD $

Money Market $ Money Market $ Other $

(SPECIFY TYPE)

6. Does the company maintain a loan balance at the bank? In what amount?

YES NO $

7. Does the company maintain an unsecured line of credit at the bank? In what amount?

YES NO $

8. What company’s standing with your bank?

Outstanding Excellent Satisfactory Poor Unsatisfactory Other Explain on separate sheet of paper

9. COMMENTS:

I certify that the above information is correct and current as of

(DATE)

SIGNATURE:

BY:

(Print name/title of authorized representative)

FA460822B0006

Attachment 9