Attachment E - Financial References Questionnaire.pdf

54 KB Posted

Attached to
FUSRAP/HTRW Verification & Laboratory Services
Solicitation number
w9
Issued by

About this file

Written by GovTribe AI ·

This document contains a financial references questionnaire to be filled out by a contractor and financial institution for a federal contract opportunity for FUSRAP/HTRW verification and laboratory services with the Department of the Army Corps of Engineers Engineering District St. Louis. The contractor must provide contact information and authorization for its financial institution to release information including average monthly balances in checking and savings accounts, any outstanding loans and payment history, credit limit, and credit rating. The financial institution must then verify the contractor's account information as of a specified date, and comment on whether the contractor is a responsible customer and has any late payments or non-sufficient funds issues.

View the file

Other files

File Type Posted
Attachment B - Cost Summary Task 2- Field Work.pdf PDF
Attachment B - Cost Summary Task 4 Laboratory Services.pdf PDF
Attachment H - Laboratory and Field Office Photos.pdf PDF
Attachment B - Cost Summary Task 1.pdf PDF
Attachment B - Cost Summary.pdf PDF
Attachment A -Small Business Participation Commitment Document.pdf PDF
Attachment F- Pre-Award Accounting Survey Checklist.pdf PDF
Attachment B - Cost Summary Task 5 Information Management.pdf PDF
Attachment D - Past Performance Questionnaire.pdf PDF
Attachment G- 1408 Accounting Survey.pdf PDF
Attachment I - Equipment List (GFE) (Sep 22).pdf PDF
A21 W912P923R0009 MVS HTRW FUSRAP Lab and Env Svcs March 2023.pdf PDF
Attachment B - Cost Summary Task 3 Project Sevices and Community Involvement.pdf PDF
Show all 13

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Financial References Questionnaire

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: __________________

I give permission for the following information regarding my account(s) at your institution to be released to Angie Grimes, Contract Specialist of the USACE-St. Louis District, Missouri.

Name/Title Signature/Date

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: _______________________________ Are there any outstanding loans: Yes/No Are payments on time: Yes/No Credit limit: _____________________________________ Are they a responsible customer: Yes/No Any late payments or NSF’s: _____________________________________ How long with this institution: _____________________________________ Credit rating with this institution: _____________________________________

Comments: ______________________________________________________________

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 .