ESBD_473696_1765226857126_3202600039 FORM_4-Financial_Questionnaire.docx
DOCX document 27 KB Posted
- Attached to
- CCRC Backup Generator
- Solicitation number
- 3202600039
- Issued by
- Travis County, Austin City, Texas
About this file
This is a Financial Questionnaire form for the CCRC Backup Generator contract opportunity with the State of Texas. The document requires respondents to provide comprehensive financial and organizational information as part of their proposal submission. Respondents must disclose any bankruptcy filings or meetings of bankruptcy criteria within the past five years, current defaults on loan or financial agreements, and any planned sales or acquisitions within twelve months following the submission deadline. Additionally, respondents must detail their company's ownership structure, including any wholly owned subsidiaries, affiliated companies, or joint ventures, with clear identification of ownership percentages for all entities involved in the proposed work.
The questionnaire further requires respondents to specify the year of company founding and incorporation details, including the state of incorporation if applicable. Respondents must identify their company headquarters location, any field offices that will provide services, the total number of employees both locally and nationally, and the specific locations from which staff will be assigned to the project. The form also requires disclosure of any prior contract history with Texas state agencies, including contract terms, specific duties performed, and the contracting agency. The entity performing the majority of work must be identified as the primary bidder, and respondents must provide both narrative and graphical representations of their proposed operating structure for the services requested under this solicitation.
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Text version
FORM 4 – FINANCIAL QUESTIONNAIRE
3202600039 CCRC Backup Generator Respondent name: ________________________
The Respondent 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 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 Respondent is an affiliate of, or has a joint venture or strategic alliance with, another company, Respondent 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, Respondent 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;
a. 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;
b. The location of company headquarters and any field office(s) that may provide services for any resulting Contract under this Solicitation;
c. 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; and
d. 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.
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