Attachment D_and_E_Surety and Financial Questionnaire Form.docx

ATTACHMENT D.1

SURETY FORM

(Bonding Capacity) (To be completed by Surety and submitted by Offeror)

Surety Name: _____________________________________________________

Agent’s Name: ____________________________________________________

Address: _________________________________________________________

Phone Number: ___________________________________________________

Contractor (Offeror) Name: ___________________________________________________

Address: __________________________________________________________________

Phone Number: _______________________________________________________________

How long have you provided bonding for the above Contractor? _______________________

How would you rate this Contactor?

Excellent Satisfactory Unsatisfactory Other ________________

If Unsatisfactory please explain:

Bonding Limit for a single project $____________________________________________

Aggregate bonding amount $_________________________________________________

Current available bonding? $________________________________________________

Have you ever had to complete a project for the Contractor? YES No

If yes, explain ______________________________________________________________

Have there been complaints of non-payment by subcontractors/suppliers? Yes No If yes, explain: _______________________________________________________________

Has the surety had to pay subcontractors/suppliers? YES NO ____

If yes, explain: ________________________________________________________________

ATTACHMENT D.2 FINANCIAL QUESTIONNAIRE

(To be completed by Financial Institution)

NAVFAC Northwest Silverdale, Washington is currently considering award of a Navy contract to this firm. Prior to award, the Navy requests the financial information listed below with regard to this firm. In order to be responsive to the Navy’s needs, it is requested that you complete this financial questionnaire with regard to this firm. Upon completion of the questionnaire, it is requested you email the completed questionnaire directly to Amanda.r.bonus.civ@us.navy.mil and nancy.m.coffee.civ@us.navy.mil and forward it to the Offeror shown below. The requested information must be received by the Government no later than _____.

Prospective Contractor for which information is being requested:

Name:__________________________________________________________________________

Address: ________________________________________________________________________

Phone Number: ________________________ Point of Contact: ________________________

Contractor Email (to be used for completed Financial Questionnaire): _________________________________________________ Signature of Prospective Contractor or Contractor Representative Request Financial Information

Name of Financial Institution: _______________________________________________________

Address:________________________________________________________________________

Phone Number: ____________________________________

Account Number: _______________________________ Type of Account: ________________________

Average Balance Figure: ____________________________ Does the Contractor have a line of credit Yes No

What is the limitation: ___________________ Remaining Balance: _________________

Does the Contractor have any outstanding loans? Yes or No (circle one)

What is the Contractor’s relationship with the bank?

Outstanding Satisfactory Other (explain) ______________________________

Would Financial Institution grant the Contractor additional monies, if necessary? Yes or No (circle one)

Name & title of person providing the above information: _________________________________________

Signature of person providing the above information Date Signed image1.png image2.png image3.png image4.png