Attachment 9 - Financial Institution Reference Sheet.pdf

2 MB Posted

Attached to
FY24 Civil Works IDIQ - Amendment 3
Solicitation number
FA446024R0005
Issued by

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This document contains a financial institution reference sheet template and details of a federal contract opportunity for FY24 Civil Works at Little Rock Air Force Base. The solicitation is for an Indefinite-Delivery Indefinite-Quantity contract to perform maintenance and repair services on various civil works construction projects. Services include demolition, concrete work, site work, electrical, utility adjustments, asphalt work, landscaping, and traffic control. Offerors must include a completed reference sheet from each financial institution where they hold business accounts disclosing information such as average balances and credit ratings to aid in the responsibility determination. The 19th Contracting Squadron at Little Rock AFB will issue task orders against the IDIQ for individual projects, which may require phased completion to facilitate base operations.

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Solicitation No.: FA446024R0005

Source Selection Information -- See FAR 2.101 and 3.104

Financial Institution Reference Sheet

FINANCIAL INSTITUTION REFERENCE SHEET

Instructions to Offeror: 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 regard 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 email address:

POC phone number: fax number:

I give permission for the following information regarding my account/s at your institution to be released to Jonathan Reed and/or Amanda Davenport of the 19th Contracting Squadron, Little Rock AFB, Arkansas.

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

Attachment 9

Source Selection Information -- See FAR 2.101 and 3.104

Source Selection Information -- See FAR 2.101 and 3.104
FINANCIAL INSTITUTION REFERENCE SHEET
TO BE FILLED OUT BY CONTRACTOR:
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:
COMPANYS NAME:
Point of Contact POC Name:
POC Phone Number:
INSTITUTION NAME:
POC name:
POC title:
POC email address:
POC phone number:
fax number:
undefined:
undefined_2:
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 NSFs:
How long with this institution:
Credit rating with this institution:
I verify that the information provided above is current as of:
undefined_4:
undefined_5:

File details come from the government source that posted it. Updated .