Attachment 24 - Financial Institution Reference Sheet v1.1 (draft) -- 20210520.pdf
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- Attached to
- FA466425R0001 - SABER MAC IDIQ B+4 @ March ARB Federal contract opportunity
- Solicitation number
- FA466424R0004
About this file
This is a financial institution reference sheet template that contractors must complete and submit as part of the contractor responsibility determination for solicitation FA466425R0001, a SABER contract at March ARB, CA.
The form requires contractors to provide company information and banking details for each financial institution they work with. The form has two sections: one to be completed by the contractor with basic contact information and authorization for release of financial information, and another to be completed by the financial institution detailing average monthly balances, loans, credit lines, payment history, length of relationship, and credit rating. The form is designed to help the 452 Operational Contracting Office assess the financial responsibility of potential contractors.
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Text version
FINANCIAL INSTITUTION REFERENCE SHEET
Instructions to Contractor: Please fill out and return 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 solicitation number FA466425R0001, Simplified Acquisition of Base Engineering Requirements (SABER), March ARB, CA.
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 452 Operational Contracting Office, March ARB, CA.
Printed Name/Title Signature/Date
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 of NSFs: ____________________________________ 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
Attachment 24
FA466425R0001
File details come from the government source that posted it. Updated .