Attachment_7_-_Financial_Institution_Reference_Sheet.doc

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CONSTRUCT CONCRETE TARGETS
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FA2823-17-R-4011
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Attachment 7 - Financial Institution Reference Sheet

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ATTACHMENT #7

FA2823-16-R-4011

FINANCIAL INSTITUTION REFERENCE SHEET

Instructions to Offeror: Please provide this completed form to AFTC/PZIOC (OL-EGLIN) with your proposal so that they can contact your banking institution if your company is the successful Offeror. The letter we will send asks how long you have had your account, estimated current line of credit, and whether or not they have received any non-payment complaints. This letter will be sent to the banking institution/s in order to make a contractor responsibility determination.

TO BE FILLED OUT BY CONTRACTOR:

COMPANY’S NAME: ____________________________________________________________

Point of Contact (POC) Name: _______________________________________________

POC Phone Number: __________________________________________________________

INSTITUTION NAME: __________________________________________________________

POC name: __________________________________________________________________

POC title: _________________________________________________________________

POC phone number: ______________________ fax number: _______________________

I give permission for the following information regarding my account/s at your institution to be released to representatives of AFTC/PZIOC (OL-EGLIN)’s Operational Contracting Division at Eglin AFB, FL.

Name/Title

Signature/Date

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