Attachment 12 Draft Financial Responsibility.pdf

PDF 73 KB Posted

Attached to
96 CTG DRAFT FOPR Federal contract opportunity
Solicitation number
FA2486-20-F-DRAFT
Issued by
Department of the Air Force Materiel Command Test Center

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FA2486-20-F-1001

Attachment 12

FINANCIAL RESPONSIBILITY QUESTIONNAIRE

SUSPENSE: In-line with Fair Opportunity Proposal Request (FOPR) Submission Deadline

Contractor Information:

Name: _______________________________________________________________________________

Address: _________________________________________________________________

Point Of Contact (POC): ________________________________________________________________

Phone/ Email: _________________________________________________________________________

To be Completed by Financial Institution:

The above named contractor is currently proposing a solution for performing services pertaining to the United States Air Force (USAF). As part of the financial responsibility determination required by FAR 9.104-1, please complete the following and return to the above Contractor POC by their need date, so the Contractor can submit their proposal no later than proposal due date.

If you have any questions, please call Maj Adam Vance at (850) 883-5265. Your assistance is appreciated.

Institution Name: _________________________________________________________________

Address: _________________________________________________________________

POC: _________________________________________________________________

Title: _________________________________________________________________

Phone: _________________________________________________________________

Email: _________________________________________________________________

1. How long has the account(s) been open? _____________________________________________

2. Over the previous six months, what is the average balance in the account?

3. Does the customer currently have (or ability to obtain) a credit line contingent upon award of this Task Order? _______________________________________

FA2486-20-F-1001

Attachment 12

If so, what amount of credit is available? ____________________________________________

4. Additional remarks, if any:________________________________________________________

Financial Institution POC:

Signature: _____________________________ Date: ___________________

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