Attch 02 Financial_Information_Request.docx

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Attached to
Multiple Award Construction Contract (MACC) at Langley AFB/Ft Eustis AB, VA Federal contract opportunity
Solicitation number
FA4800-11-R-0002
Issued by
Department of the Air Force Air Combat Command

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Attachment 02 Financial Information Request

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MEMORANDUM FOR WHOM IT MAY CONCERN

FROM: 633 CONS/LGCB

74 Nealy Avenue Langley AFB VA 23665-2088

SUBJECT: Financial Information Request and Release Authorization

REFERENCES:(a)Solicitation FA4800-11-R-0002
(b)Multiple Award Construction Contract (MACC)
1.Our office is evaluating
(NAME OF FIRM)

of

(FIRM’S ADDRESS, INCLUDING CITY, STATE, AND ZIP CODE)

for possible award of referenced contract. In order to proceed, we must verify the contractor’s financial capability. The firm has provided your name as their bank reference and granted you release, as indicated below, to provide it to the government.

2. Please complete the attached questionnaire and return it by fax (757-764-4071) or email to me (delores.powell@langley.af.mil) at your earliest convenience, but not later than seven (7) calendar days after receipt of this request.

3. All information provided will be FOR OFFICIAL USE ONLY and will not be publicly released. If you need any other information or have any questions, please call me at 757-764-2597. Thank you very much for your assistance.

MICHAEL J. COSTLOW
Contracting Officer

Attachment Financial Information Sheet

1st Ind, (Name of Offeror’s Firm) (Date)

TO:

(Name of Financial Institution) (Phone # w/Area Code)

|_| I hereby authorize the financial institution to release my information as requested.

SIGNATURE:

BY:

(Print name/title of authorized representative)

FA4800-11-R-0002

ATTACHMENT 02

FA4800-11-R-0002

ATTACHMENT 02

Global Power For America

RESPONSIBILITY QUESTIONNAIRE - FINANCIAL

FA4800-11-R-0002

MULTIPLE AWARD CONSTRUCTION CONTRACT (MACC)

1. Name of Contractor to whom the following information is applicable:

2. Name of Financial Institution:

3. Address of Financial Institution:

4. How long has the firm been a commercial customer of your bank?

5. What is the type of account and its average* balance? (continue on separate sheet if necessary)

|_| Checking $|_| Checking $
|_| Savings $|_| Savings $
|_| CD $|_| CD $
|_| Money Market $|_| Money Market $
|_| Other$
(SPECIFY TYPE)

6. Does the company maintain a loan balance at the bank? In what amount?

|_| YES |_| NO $

7. Does the company maintain an unsecured line of credit at the bank? In what amount?

|_| YES |_| NO $

8. What company’s standing with your bank?

|_| Outstanding |_| Excellent |_| Satisfactory |_| Poor |_| Unsatisfactory |_| Other Explain on separate sheet of paper

9. COMMENTS:

I certify that the above information is correct and current as of

(DATE)

SIGNATURE:

BY:

(Print name/title of authorized representative)

DATE:

File details come from the government source that posted it. Updated .