ESBD_437603_1753105610286_04_3202500269 Form 3 Financial Questionnaire.pdf
PDF 110 KB Posted
- Solicitation number
- 3202500269
- Issued by
- Texas
About this file
This document is a Form 3 Financial Questionnaire for a state and local contract opportunity, likely associated with the Texas Workforce Commission (TWC). The form requires bidders to provide comprehensive financial and organizational details to qualify for a potential contract. The questionnaire seeks detailed information about the bidding company's financial history, including any bankruptcy filings in the past five years, current loan defaults, potential sale or acquisition plans, ownership structure, company founding date, headquarters location, employee count, and previous experience with Texas state agencies.
The form is designed to thoroughly assess a bidder's financial stability, organizational structure, and capacity to perform contract work. Key sections require bidders to disclose ownership percentages, joint venture arrangements, proposed operating structures, employee locations, and prior state contract experience. By collecting this detailed information, the TWC aims to evaluate the financial health, operational capabilities, and reliability of potential contractors before making a contract award. The form does not specify the exact nature of the services being solicited, but it provides a comprehensive framework for financial and organizational transparency from bidding companies.
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Text version
FORM 3 – FINANCIAL QUESTIONNAIRE
Bidder name: ________________________
The Bidder must provide the following information. If more space is needed for the explanation, please attach additional page(s) as necessary:
a. Indicate if your company or any of its subsidiaries filed or met criteria for bankruptcy within the past five (5) years, if so, provide explanation.
b. Indicate if your firm is currently in default on any loan agreement or financial agreement institution, or other entity. If so, specify date(s), details, circumstances, and prospect resolution.
c. Identify if your company is currently for sale or involved in any transaction to expand or become acquired by another business entity during the next twelve (12) months following the Bid Submission Deadline. If so, explain the impact both in organization and company director.
d. Ownership structure (e.g., corporation, partnership, LLC, or sole proprietorship), including any wholly owned subsidiaries, affiliated companies, or joint ventures. (Please provide this information both in a narrative and as a graphical representation.)
1. If Bidder is an affiliate of, or has a joint venture or strategic alliance with, another company, Bidder must identify the percentage of ownership of each joint venture member or affiliate and the percentage of the parent company’s ownership. The entity performing the majority of the work under any Contract resulting from this Solicitation, throughout the duration of the Contract, must be the primary Bidder.
2. Finally, Bidder must provide its proposed operating structure for the services requested under this Solicitation and which entities (i.e., parent company, affiliate, joint venture, subcontractor) will be performing the services;
e. The year the company was founded and/or incorporated. If incorporated, please indicate the state where the company is incorporated and the date of incorporation;
f. The location of company headquarters and any field office(s) that may provide services for any resulting Contract under this Solicitation;
g. The number of employees in the company, both locally and nationally, and the location(s) from which employees will be assigned to TWC’s project.
h. Indicate whether the company has ever been in contract with any Texas state agency. If “Yes,” specify the contract term, for what duties, and with which agency.
FORM 3 – FINANCIAL QUESTIONNAIRE
| Bidder name: |
| for bankruptcy within the past five 5 years if so provide explanation 2: |
| for bankruptcy within the past five 5 years if so provide explanation 3: |
| for bankruptcy within the past five 5 years if so provide explanation 4: |
| for bankruptcy within the past five 5 years if so provide explanation 5: |
| for bankruptcy within the past five 5 years if so provide explanation 6: |
| for bankruptcy within the past five 5 years if so provide explanation 7: |
| circumstances and prospect resolution 1: |
| circumstances and prospect resolution 2: |
| circumstances and prospect resolution 3: |
| circumstances and prospect resolution 4: |
| circumstances and prospect resolution 5: |
| circumstances and prospect resolution 6: |
| circumstances and prospect resolution 7: |
| explain the impact both in organization and company director 1: |
| explain the impact both in organization and company director 2: |
| explain the impact both in organization and company director 3: |
| 1: |
| 2: |
| 3: |
| 4: |
| performing the services 1: |
| performing the services 2: |
| performing the services 3: |
| performing the services 4: |
| performing the services 5: |
| performing the services 6: |
| incorporation 1: |
| incorporation 2: |
| incorporation 3: |
| incorporation 4: |
| incorporation 5: |
| provide services for any resulting Contract under this Solicitation 1: |
| provide services for any resulting Contract under this Solicitation 2: |
| provide services for any resulting Contract under this Solicitation 3: |
| provide services for any resulting Contract under this Solicitation 4: |
| provide services for any resulting Contract under this Solicitation 5: |
| 1_2: |
| 2_2: |
| 3_2: |
| 4_2: |
| 5: |
| which agency 1: |
| which agency 2: |
| which agency 3: |
| which agency 4: |
| which agency 5: |
| for bankruptcy within the past five 5 years if so provide explanation 1: |
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