Sources Sought - Atch.2 -- Statement of Financial Capability.docx
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- Solicitation number
- DE-SOL-0002014
- Issued by
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Department of Energy Headquarters
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Sources Sought - Atch.2 -- Statement of Financial Capability.docx
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| Sources Sought - Atch. 3 -- Accounting System Questionnaire.docx | DOCX document |
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Financial Statement of Capability
PART A – GENERAL
| 1. TYPE OF COMPANY (SMALL BUSINESSES ONLY) |
| 3. NAME AND ADDRESS OF: |
Top of Form
CORPORATION
Bottom of Form Top of Form
PARTNERSHIP
Bottom of Form
a. COMPANY
Top of Form
SUBSIDIARY
Bottom of Form Top of Form
DIVISION
Top of Form
PROPRIETORSHIP
Bottom of Form Top of Form OTHER (Specify) Bottom of Form
b. PARENT CO AND SUBSIDIARIES (IF APPLICABLE)
2. YEAR ESTABLISHED
SECTION III - BALANCE SHEET/PROFIT AND LOSS STATEMENT
| PART A - LATEST BALANCE SHEET |
| PART B - LATEST PROFIT AND LOSS STATEMENT |
| 1. DATE |
| 2. FILED WITH |
| 1. CURRENT PERIOD |
| 2. FILED WITH |
| a. FROM |
| b. TO |
3. FINANCIAL POSITION
3. NET SALES
| a. CURRENT PERIOD |
| $ |
| a. Cash |
| $ |
b. Accounts Receivable
b. First prior fiscal year
c. Inventory
c. Second prior fiscal year
d. Other Current Assets
4. NET PROFITS BEFORE TAXES
e. Total Current Assets
| a. CURRENT PERIOD |
| $ |
f. Fixed Assets
b. First prior fiscal year
g. Current Liabilities
c. Second prior fiscal
h. Long Term Liabilities
PART C – OTHER
I. Total liabilities
1. FISCAL YEAR ENDS (Date):
j. Net Worth
2. ARE BALANCE SHEETS AND PROFIT AND LOSS STATEMENTS CERTIFIED? YES |_| NO |_|
a.) Through (DATE) b.) By (Signature)
4. WORKING CAPITAL (Current Assets less Current Liabilities)
| 5. CURRENT PERIOD RATIOS |
| 3. OTHER PERTINENT DATA (if applicable, attach continuation sheet) |
a. CURRENT ASSETS TO CURRENT LIABILITIES
| b. ACID TEST (Cash, temporary investment held in lieu of cash and current receivable to current liabilities) |
| c. Total Liabilities To Net Worth |
| d. PROFIT MARGIN (Net Profit To Sales) |
PART B - CONTRACTOR’S FINANCIAL ARRANGEMENTS
| Mark "X" in appropriate column. |
| YES |
| NO |
| 4. ATTACHED DOCUMENTATION SUPPORTS STATEMENTS SHOWN IN ITEMS 1, 2, AND 3 |
Top of Form
YES
NO (If "NO", explain)
1. USE OF OWN RESOURCES
2. USE OF BANK CREDITS
3. OTHER (Specify)
PART C – GOVERNMENT ASSISTANCE
| 1. TO BE REQUESTED IN CONNECTION WITH PERFORMANCE OF PROPOSED CONTRACT |
| 2. EXPLAIN ANY "YES" ANSWERS TO ITEMS 1a AND b |
| Mark "X" in appropriate column. |
| YES |
| NO |
a. GUARANTEED LOAN
b. ADVANCE PAYMENTS
3. FINANCIAL AID CURRENTLY OBTAINED FROM THE GOVERNMENT
a. PROSPECTIVE CONTRACTOR RECEIVES GOVERNMENT FINANCING AT PRESENT Top of Form
YES
NO
Complete Items below only if items a, marked "YES"
b. IS LIQUIDATION CURRENT?
Top of Form
YES
NO
Bottom of Form
| C. AMOUNT OF LIQUIDATED PROGRESS PAYMENTS OUTSTANDING $ |
| DOLLAR AMOUNTS |
| (a) AUTHORIZED |
| (b) IN USE |
| a. Guaranteed loans |
| $ |
| $ |
| b. Advance Pmts |
| $ |
| $ |
| 4. LIST THE GOVERNMENT AGENCIES INVOLVED |
| 5. SHOW THE APPLICABLE CONTRACT NOS. |
PART D - SALES (000’S) PROJECTION FOR NEXT SIX QUARTERS
| CATEGORY |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| TOTAL |
| 1. CURRENT CONTRACT SALES (Backlog) |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
A. GOVERNMENT (Prime & Subcontractor)
B. COMMERCIAL
2. ANTICIPATED ADDITIONAL SALES
A. GOVERNMENT (Prime & Subcontractor)
B. COMMERCIAL
3. TOTALS
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