Attach 6 Financial_1.pdf
PDF 149 KB Posted
- Attached to
- ABSORBENT MATERIALS DIVERSION
- Solicitation number
- FA670326Q0011
About this file
This is a Financial Institution Reference Sheet template used as an evaluation document for contractor responsibility determination under federal solicitation FA670326Q0011 for Absorbent Materials Diversion services at Dobbins Air Reserve Base, Georgia.
The form requires contractors to provide information about each financial institution where they maintain business accounts. The contractor section requests company name, point of contact information, and institutional details including the financial institution name, contact person, title, phone number, and fax number. Contractors must authorize the 94th Contracting Flight at Dobbins ARB to contact their financial institutions to verify account information. The financial institution section, completed by the bank, requests average monthly balances in checking and savings accounts (provided as ranges such as low four figures or mid six figures), current loan amounts, available lines of credit, history of late payments or non-sufficient funds, length of relationship with the institution, and the institution's credit rating assessment. The financial institution representative must verify that all information is current as of a specified date and sign the form accordingly. This reference sheet serves as documentation of the contractor's financial stability and responsibility as part of the solicitation evaluation process.
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Other files
| File | Type | Posted |
|---|---|---|
| Attach 3 AFFARS_1.pdf | ||
| Attach 4 WD_2.pdf | ||
| Solicitation - FA670326Q0011.pdf | ||
| Attach 1 PWS_2.pdf | ||
| Attach 2 Price Schedule_1.docx | DOCX document | |
| Attach 5 DARB 4.pdf |
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Attach 6 Aug 19 2026 FA670326Q0011
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 FA670326Q- 0011, Absorbent Materials Diversion, Dobbins ARB, GA.
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 94th Contracting Flight, Dobbins ARB, GA.
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
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 responsibi...
File details come from the government source that posted it. Updated .