Attch 5 - Financial Worksheet.docx
DOCX document 22 KB Posted
- Attached to
- Repair Interiors 505 TRS and 705 TRS, Bldg 90021
- Solicitation number
- FA441720R0015
About this file
This document contains an attachment requesting financial reference information from contractors responding to solicitation number FA441720R0015. The solicitation is for repair work interiors of buildings 505 TRS and 705 TRS located at building 90021. The work includes partial demolition and new construction of a first and second floor interior build out. The first floor will include new bathrooms, mechanical room, classrooms, labs and support spaces. The second floor will include breakrooms, bathrooms, mechanical room, offices, classrooms, training conference rooms and other supporting spaces. A new prefabricated metal stairway with precast treads and landings will also be installed. The attachment requests contractors provide financial reference sheets from financial institutions with information including average monthly balances, current loans and lines of credit, late payments or NSFs, and credit length and rating. The sheets will be sent to the financial institutions for verification as part of the responsibility determination for award.
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Text version
ATTACHMENT 5
FA441720R0015
Financial Reference Worksheet
FINANCIAL INSTITUTION REFERENCE SHEET
30 Jun 2020
Instructions to Contractor: 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 regards 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 phone number: ______________________ fax number: _______________________
I give permission for the following information regarding my account/s at your institution to be released to representatives of the 1st Special Operations Contracting Squadron, Hurlburt Field, FL.
| _____________________________________ | ________________________________ | |
| 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 |
File details come from the government source that posted it. Updated .