Attachment 7- Financial Institution Reference Sheet.docx
DOCX document 28 KB Posted
- Attached to
- Minot MAF Refuse
- Solicitation number
- FA4528-24-Q-JKB03
About this file
This document is a Financial Institution Reference Sheet that is required to be submitted as an attachment to the solicitation FA4528-24-Q-JKB03 for refuse removal and disposal services at Minot Air Force Base.
The Reference Sheet instructs the contractor to provide information about their business bank accounts, including the financial institution name, point of contact, account details, and average account balances. The financial institution is then required to verify the account information and provide additional details such as any late payments, lines of credit, and the contractor's credit rating with the institution. This information may be used to determine contractor responsibility as part of the evaluation for the award of the solicitation. The solicitation is for a 1-year contract with 4 option years, as outlined in the Performance Work Statement and Quality Assurance Surveillance Plan attachments.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 1 - MAF Refuse PWS 2024 (Updated)(29 Aug 24).pdf | ||
| MAF Refuse Q and A (Updated)(29 Aug 24).pdf | ||
| MAF Refuse Q and A (Updated)(22 Aug 24).pdf | ||
| Attachment 4 - Pricing Schedule.xlsx | XLSX spreadsheet | |
| Attachment 5 - SCA Wage Determination.pdf | ||
| Attachment 6 - PPIF.docx | DOCX document | |
| Attachment 3 - Basis for Award.docx | DOCX document | |
| Combo FA4528-24-Q-JKB03.pdf | ||
| MAF Refuse Q and A.pdf | ||
| Attachment 2 - QASP ISWM 2024.pdf | ||
| Combo FA4528-24-Q-JKB03.pdf | ||
| Attachment 1 - MAF Refuse PWS 2024.pdf |
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Text version
FA4528-24-Q-JKB03
Attachment 7 - Page 1 of 2
FINANCIAL INSTITUTION REFERENCE SHEET
Instructions to Contractor: Include with your offer a reference sheet for each financial institution that you have a business account with. This sheet may be sent to the banking institution(s) regarding 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: ________________POC Email: _ _______________ Account Number: ___________________
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__________________
File details come from the government source that posted it. Updated .