Exhibit F - Financial and Orginizational Capacity 03.07.2024.docx
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- Attached to
- Qualitative Respirator Fit Tests
- Solicitation number
- 5510000951
- Issued by
- Texas
About this file
This is Exhibit F, a Financial and Organizational Capacity questionnaire document issued by the Texas Department of Agriculture for use in state and local contract opportunities. The exhibit serves as a qualification and attestation form that respondents must complete to demonstrate their financial stability and organizational capacity to perform contracted work.
The questionnaire requires respondents to disclose any financial or organizational deficiencies within specified timeframes. Specifically, respondents must indicate whether they have failed to file or pay required tax returns in the past three years; received unsatisfactory performance assessments from government entities, had liquidated damages exceeding $25,000, or had unresolved liens or judgments over $25,000 within the past five years; or initiated or been subject to bankruptcy proceedings within the past seven years. Additionally, respondents must confirm they have sufficient resources to perform under the state's payment process, which includes a 30-day payment window after invoice receipt and acceptance of goods or services, with earlier payment available only through early pay discounts. The form requires the vendor's signature, date, printed name, and company name, with all information attested to as complete and accurate by the signatory.
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Text version
Texas Department of Agriculture – Exhibit F Exhibit F
FINANCIAL AND ORGANIZATIONAL CAPACITY
UNDER ANY NAME OR BUSINESS ENTITY:
A. During the past three (3) years, has the Respondent failed to file or pay any tax returns required by federal, state, or local tax laws?
|_| No |_| Yes, with explanation:
B. Within the past five (5) years, has the Respondent
1) Received any formal unsatisfactory performance assessment(s) from any government entity on any contract?
|_| No |_| Yes, with explanation:
2) Had any liquidated damages assessed over $25,000?
|_| No |_| Yes, with explanation:
3) Had any liens or judgments over $25,000 filed against the company, other than UCC filings, which have not been discharged?
|_| No |_| Yes, with explanation:
C. In the last seven (7) years, has the Respondent initiated or been the subject of any bankruptcy proceedings, or is any bankruptcy proceeding pending?
|_| No |_| Yes, with explanation:
D. The State of Texas regulates the timing of payments. Payment cannot be made before goods are received or services rendered and have been accepted. The State has 30 days after receipt of a correct invoice to make payment. Earlier payment is contingent upon offering an early pay discount. Does the Respondent have sufficient resources available to perform as contracted notwithstanding the state’s payment process?
|_| Yes
SIGNATURE AND DATE
I hereby attest that all information provided is complete and accurate to the best of my knowledge.
| Vendor Signature |
| Date |
| Printed Name |
| Company Represented |
|_| No, with explanation:
Exhibit F – 03/07/2024 Page 2 of 2
File details come from the government source that posted it. Updated .