Attach_5-_Financial_Reference_Sheet.pdf
PDF 102 KB Posted
- Attached to
- Replace Munitions Storage Area Lighting Federal contract opportunity
- Solicitation number
- FA441718R0014
About this file
This document contains an attachment template for a financial reference sheet to be included with proposals for solicitation number FA441718R0014 to replace munitions storage area lighting for the Department of the Air Force Special Operations Command. The financial reference sheet requests information such as average monthly balances, current loans and lines of credit from a contractor's financial institution. It authorizes the release of this information to representatives evaluating proposals. Financial institutions would provide the requested data directly on the sheet, including credit ratings and length of relationships.
FA441718R0014 Attach 5- Financial Reference Sheet
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Questions_and_Answers_FA441718R0014_MSA_Lighting.pdf | ||
| FA441718R0014_0002_Amendment.pdf | ||
| Pre-Proposal_Site_Visit_Memo.pdf | ||
| Site_Visit_Sign_In_Sheet.pdf | ||
| FA441718R0014_Amendment_1.pdf | ||
| Attach_3-_Wage_Determination.pdf | ||
| Attach_6_-_Additional_Contract_Requirements_-_3_Jul_18.pdf | ||
| Attach_4-_Past_Performance_Questionnaire-_3_Jul_18.pdf | ||
| Attach_1-_Specifications_5_July_18.pdf | ||
| FA441718R0014.pdf | ||
| Attach_2-_Drawings.pdf |
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Text version
ATTACHMENT 5
FA4417-18-R-0014
Financial Reference Worksheet
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 1st Special Operations Contracting Squadron, Hurlburt Field, FL.
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
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