Financial Institution Reference Sheet.pdf
PDF 14 KB Posted
- Attached to
- Marina Covered Storage Facility
- Solicitation number
- FA309925R0001
About this file
This is a Financial Institution Reference Sheet template required as part of a proposal submission for a marina covered storage facility project at Laughlin AFB. The form has two main sections - one to be completed by the contractor and another section that will only be completed by the financial institution if the contractor becomes the potential awardee.
The form requires contractors to provide company details, point of contact information, and banking institution references. The financial institution portion requests information about average monthly balances in checking and savings accounts, current loans, lines of credit, payment history (including any late payments or NSFs), length of relationship with the institution, and credit rating. All financial amounts are to be provided as ranges (e.g., low four figures, mid six figures). The form is administered by the 47th Contracting Flight at Laughlin AFB, TX and requires signed authorization from the contractor to release their banking information.
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Text version
FINANCIAL INSTITUTION REFERENCE SHEET
Instructions to Contractor: Include with your proposal a reference sheet for each financial institution that you have a business account with. This sheet may be sent to the banking institution/s in regards to a determination of contractor responsibility as part of the evaluation for award of this solicitation.
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 the 47th Contracting Flight, Laughlin AFB, TX 78843
Name/Title Signature/Date
DO NOT HAVE THIS SECTION FILLED OUT. IF YOUR FIRM IS SELECTED AS THE POTENTIAL
AWARDEE, THIS FORM WILL BE SENT TO YOUR BANKING INSTITUTION FOR COMPLETION.
TO BE FILLED OUT BY FINANCIAL INSTITUTION:
Please give amounts as a range – i.e. low four figures, mid six figures, etc.
Average monthly balance in checking: ________________
Average monthly balance in savings: _________________
Amount of any current loans: ______________
Amount of any lines of credit: ______________
Any late payments or NSF’s? ______________
How long with this institution: ______________
Credit rating with this institution: ______________
I verify that the information provided above is current as of ____________.
Name/Title Signature/Date
| TO BE FILLED OUT BY CONTRACTOR: |
| TO BE FILLED OUT BY FINANCIAL INSTITUTION: |
File details come from the government source that posted it. Updated .