Attachment 8 - Financial Responsibility Questionnaire 20220331.docx

FA002122R0002

Attachment 8

FINANCIAL RESPONSIBILITY QUESTIONNAIRE

SUSPENSE:

Contractor Information:

Name:

Address:

POC & Phone:

Financial Institution:

The above named contractor is currently competing to perform services under a contract for HQ AFSOC at Hurlburt Field, FL. As part of the financial responsibility determination required by FAR 9.104-1, please provide the following information to be included in the contractor's proposal submission. Any questions can be directed to the contractor POC or to the Contracting Officer, Ms. Christine Basham, email christine.basham.1@us.af.mil. Your assistance is appreciated.

Institution Name:

Address:

POC:

Title:

Phone:

How long has the account(s) been open?

What is the average account balance? (ex: high 6 figure, low 8 figure, etc.)

Does the customer have a credit line available?

If yes, what amount of credit is available? (ex: high 6 figure, low 8 figure, etc.)

Is the customer in good standing?

Does the institution feel comfortable continuing to support the customer in their business endeavors?

Additional Remarks (if any):

Signature: Date: