JA-15_Financial_Reference_Sheet.pdf

PDF 14 KB Posted

Attached to
Hangar Door Repair Federal contract opportunity
Solicitation number
FA5004-15-R-C003
Issued by
Department of the Air Force Pacific Air Forces

About this file

JA-15 Financial Reference Sheet

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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 354th Contracting Squadron, Eielson AFB, Alaska.

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

FY15 HANGAR DOOR PROJECT ATTACHMENT JA-15

EIELSON AFB, ALASKA PAST PERFORMANCE WORKSHEET

FTQW 06-1025 SOLICITATION FA5004-15-R-C003

TO BE FILLED OUT BY CONTRACTOR:
TO BE FILLED OUT BY FINANCIAL INSTITUTION:

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