Attachment 5 - Financial Reference.docx
DOCX document 16 KB Posted
- Attached to
- Flooring MACC IDIQ Federal contract opportunity
- Solicitation number
- FA452821R0006
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Solicitation - FA452821R0006.pdf | ||
| Attachment 7 - Section L - Instructions to Offerors.docx | DOCX document | |
| Attachment 2 - MACC Provisions.docx | DOCX document | |
| Attachment 9 - Subcontractor Consent.docx | DOCX document | |
| Attachment 3 - Building WD.pdf | ||
| Attachment 6 - FOPR for Seed Project.doc | DOC document | |
| Attachment 10 - Seed SOW Bldg 165 Flooring.doc | DOC document | |
| Attachment 11 - Seed Drawing Bldg 165.pdf | ||
| Attachment 1 - Flooring IDIQ SOW.docx | DOCX document | |
| Attachment 8 - Section M - Evaluations.docx | DOCX document | |
| Attachment 4 - Past Performance Information Form.docx | DOCX document |
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Text version
FA452821R0006
Attachment 5
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 email address:____________________________________________________________ POC title: ____________________________________________________________________ POC phone number: ______________________ fax number: ___________________________ Account #_______________________________
I give permission for the following information regarding my account/s at your institution to be released to representatives of the 5th Contracting Squadron, Minot AFB, North Dakota.
| _____________________________________ | _____________________________________ | |
| 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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