L2. SF 1407 PreAward Survey of Prospective Contractor (Financial Capability) [dRFPv2].pdf

3. NARRATIVE (Cite those sections of the report which substantiate the recommendation. Give any other backup information in this space or on an additional sheet, if necessary.)

PRE-AWARD SURVEY OF

PROSPECTIVE CONTRACTOR

(FINANCIAL CAPABILITY)

SERIAL NUMBER (For surveying activity use)

PROSPECTIVE CONTRACTOR

OMB Control Number: 9000-0011 Expiration Date: 1/31/2024

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0011. We estimate that it will take 24 hours to read the instructions, gather the facts, and answer the questions.

Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S.

General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

SECTION I - RECOMMENDATION

1. RECOMMENDED

a. COMPLETE AWARD b. PARTIAL AWARD c. NO AWARD(Quantity: )

2. TOTAL OFFERED PRICE

4. SURVEY

MADE BY

5. SURVEY

REVIEWING

OFFICIAL

a. SIGNATURE b. TELEPHONE NUMBER (Include area code)

c. DATE SIGNED

a. SIGNATURE b. TELEPHONE NUMBER (Include area code)

c. DATE REVIEWED

IF CONTINUATION SHEETS

ATTACHED - MARK HERE

STANDARD FORM 1407 (REV. 1/2014)

Prescribed by GSA - FAR (48 CFR) 53.209-1(e)

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is NOT usable.

a. PROSPECTIVE

CONTRACTOR

RECEIVES

GOVERNMENT

FINANCING AT

PRESENT

SECTION II - GENERAL

SECTION III - BALANCE SHEET/PROFIT AND LOSS STATEMENT

SECTION IV - PROSPECTIVE CONTRACTOR'S FINANCIAL ARRANGEMENTS

SECTION V - GOVERNMENT FINANCIAL AID

3. FINANCIAL AID CURRENTLY OBTAINED FROM THE GOVERNMENT

4. LIST THE GOVERNMENT AGENCIES INVOLVED 5. SHOW THE APPLICABLE CONTRACT NUMBERS

Complete items below only if item a., is marked "YES."

PART A - LATEST BALANCE SHEET

3. FINANCIAL POSITION

5. RATIOS

PART B - LATEST PROFIT AND LOSS STATEMENT

1. TYPE OF COMPANY

2. YEAR ESTABLISHED:

CORPORATION

OTHER (Specify)

DIVISION

PARTNERSHIP

SUBSIDIARY

PROPRIETORSHIP

3. NAME AND ADDRESS OF:

a. PARENT COMPANY

b. SUBSIDIARIES

1. DATE 2. FILED WITH 1. CURRENT PERIOD

PART C - OTHER

1. FISCAL YEAR ENDS (Date):

a. FROM b. TO

2. FILED WITH

a. Cash

b. Accounts Receivable

c. Inventory

d. Other Current Assets

e. Total Current Assets

f. Fixed Assets

g. Current Liabilities

h. Long Term Liabilities

i. Total Liabilities

j. Net Worth

4. WORKING CAPITAL (Current Assets less Current Liabilities)

a. CURRENT ASSETS

TO CURRENT

LIABILITIES

c. TOTAL LIABILITIES

TO NET WORTH

b. ACID TEST (Cash, temporary investments held in lieu of cash and current receivables to current liabilities)

3. NET SALES

4. NET PROFITS

BEFORE TAXES

a. CURRENT PERIOD

b. First prior fiscal year

c. Second prior fiscal year

a. CURRENT PERIOD

b. First prior fiscal year

c. Second prior fiscal year

2. BALANCE SHEETS

AND PROFIT AND LOSS

STATEMENTS HAVE

BEEN CERTIFIED

a. THROUGH (Date) b. BY (Signature)

3. OTHER PERTINENT DATA

4. INDEPENDENT ANALYSIS OF FINANCIAL POSITION SUPPORTS THE STATEMENTS SHOWN IN ITEMS 1, 2, AND 3

2. EXPLAIN ANY "YES" ANSWERS TO ITEMS 1a, b, AND c.

YES NO (If "NO", explain)

Mark "X" in appropriate column.

1. USE OF OWN RESOURCES

2. USE OF BANK CREDITS

3. OTHER (Specify)

YES NO

Mark "X" in appropriate column.

a. PROGRESS PAYMENT(S)

b. GUARANTEED LOAN

c. ADVANCE PAYMENTS

YES NO

1. TO BE REQUESTED IN CONNECTION

WITH PERFORMANCE OF PROPOSED

CONTRACT

YES NO NO $

b. IS LIQUIDATION

CURRENT?

c. AMOUNT OF UNLIQUIDATED

PROGRESS PAYMENTS

OUTSTANDING

YES

DOLLAR AMOUNTS (a) AUTHORIZED (b) IN USE

a. Guaranteed loans

b. Advance payments

STANDARD FORM 1407 (REV. 1/2014) PAGE 2

SECTION VI - BUSINESS AND FINANCIAL REPUTATION

SECTION VII - SALES (000'S) FOR NEXT SIX QUARTERS

1. COMMENTS OF PROSPECTIVE CONTRACTOR'S BANK

2. COMMENTS OF TRADE CREDITORS

3. COMMENTS AND REPORTS OF COMMERCIAL FINANCIAL SERVICES AND CREDIT ORGANIZATIONS (Such as, Dun & Bradstreet, Standard and Poor's, etc.)

6. DESCRIBE ANY OUTSTANDING LIENS OR JUDGEMENTS

4. MOST RECENT

CREDIT RATING

5. DOES PRICE APPEAR UNREALISTICALLY LOW?

a. DATE b. BY

YES NO (If Yes, explain in Section I NARRATIVE)

CATEGORY

1. CURRENT CONTRACT SALES (Backlog)

2. ANTICIPATED ADDITIONAL SALES

3. TOTALS

A. GOVERNMENT (Prime & Subcontractor)

B. COMMERCIAL

A. GOVERNMENT (Prime & Subcontractor)

B. COMMERCIAL

1 2 3 4 5 6 TOTAL

STANDARD FORM 1407 (REV. 1/2014) PAGE 3

3. NARRATIVE (Cite those sections of the report which substantiate the recommendation. Give any other backup information in this space or on an additional sheet, if necessary.)

PRE-AWARD SURVEY OF

PROSPECTIVE CONTRACTOR

(FINANCIAL CAPABILITY)

SERIAL NUMBER (For surveying activity use)

PROSPECTIVE CONTRACTOR

OMB Control Number: 9000-0011 Expiration Date: 1/31/2024 Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0011. We estimate that it will take 24 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

SECTION I - RECOMMENDATION

1. RECOMMENDED

a. COMPLETE AWARD

b. PARTIAL AWARD

c. NO AWARD (Quantity:

2. TOTAL OFFERED PRICE

4. SURVEY MADE BY

5. SURVEY REVIEWING OFFICIAL

a. SIGNATURE

b. TELEPHONE NUMBER(Include area code)

c. DATE SIGNED

a. SIGNATURE

b. TELEPHONE NUMBER(Include area code)

c. DATE REVIEWED

IF CONTINUATION SHEETS ATTACHED - MARK HERE

STANDARD FORM 1407 (REV. 1/2014)

Prescribed by GSA - FAR (48 CFR) 53.209-1(e)

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is NOT usable.

a. PROSPECTIVE CONTRACTOR RECEIVES GOVERNMENT FINANCING AT PRESENT \\iaimain\apps1\Pam_Ward\Logos\Pointer.jpg Image of a right arrow pointing to the next field, a. Through (Date).

SECTION II - GENERAL

SECTION III - BALANCE SHEET/PROFIT AND LOSS STATEMENT

SECTION IV - PROSPECTIVE CONTRACTOR'S FINANCIAL ARRANGEMENTS

SECTION V - GOVERNMENT FINANCIAL AID

3. FINANCIAL AID CURRENTLY OBTAINED FROM THE GOVERNMENT

4. LIST THE GOVERNMENT AGENCIES INVOLVED

5. SHOW THE APPLICABLE CONTRACT NUMBERS

Complete items below only if item a., is marked "YES."

PART A - LATEST BALANCE SHEET

3. FINANCIAL POSITION

5. RATIOS

PART B - LATEST PROFIT AND LOSS STATEMENT

1. TYPE OF COMPANY

2. YEAR ESTABLISHED:

CORPORATION

OTHER (Specify)

DIVISION

PARTNERSHIP

SUBSIDIARY

PROPRIETORSHIP

3. NAME AND ADDRESS OF:

a. PARENT COMPANY

b. SUBSIDIARIES

1. DATE

2. FILED WITH

1. CURRENT PERIOD

PART C - OTHER

1. FISCAL YEAR ENDS (Date):

a. FROM

b. TO

2. FILED WITH

a. Cash

b. Accounts Receivable

c. Inventory

d. Other Current Assets

e. Total Current Assets

f. Fixed Assets

g. Current Liabilities

h. Long Term Liabilities

i. Total Liabilities

j. Net Worth

4. WORKING CAPITAL (Current Assets less Current Liabilities)

a. CURRENT ASSETS

TO CURRENT LIABILITIES

c. TOTAL LIABILITIES TO NET WORTH

b. ACID TEST (Cash, temporary investments held in lieu of cash and current receivables to current liabilities)

3. NET SALES

4. NET PROFITS BEFORE TAXES

a. CURRENT PERIOD

b. First prior fiscal year

c. Second prior fiscal year

a. CURRENT PERIOD

b. First prior fiscal year

c. Second prior fiscal year

2. BALANCE SHEETS AND PROFIT AND LOSS STATEMENTS HAVE BEEN CERTIFIED

a. THROUGH (Date)

b. BY (Signature)

3. OTHER PERTINENT DATA

4. INDEPENDENT ANALYSIS OF FINANCIAL POSITION SUPPORTS THE STATEMENTS SHOWN IN ITEMS 1, 2, AND 3

2. EXPLAIN ANY "YES" ANSWERS TO ITEMS 1a, b, AND c.

YES

NO (If "NO", explain) Mark "X" in appropriate column.

1. USE OF OWN RESOURCES

2. USE OF BANK CREDITS

3. OTHER (Specify)

YES

NO

Mark "X" in appropriate column.

a. PROGRESS PAYMENT(S)

b. GUARANTEED LOAN

c. ADVANCE PAYMENTS

YES

NO

1. TO BE REQUESTED IN CONNECTION WITH PERFORMANCE OF PROPOSED CONTRACT

YES

NO

NO

b. IS LIQUIDATION CURRENT?

c. AMOUNT OF UNLIQUIDATED PROGRESS PAYMENTS OUTSTANDING

YES

DOLLAR AMOUNTS

(a) AUTHORIZED

(b) IN USE

a. Guaranteed loans

b. Advance payments

STANDARD FORM 1407 (REV. 1/2014) PAGE 2

\\iaimain\apps1\Pam_Ward\Logos\Pointer.jpg Image of a right arrow pointing to the next field, 4. Most Recent Credit Rating. a. Date.

SECTION VI - BUSINESS AND FINANCIAL REPUTATION

SECTION VII - SALES (000'S) FOR NEXT SIX QUARTERS

1. COMMENTS OF PROSPECTIVE CONTRACTOR'S BANK

2. COMMENTS OF TRADE CREDITORS

3. COMMENTS AND REPORTS OF COMMERCIAL FINANCIAL SERVICES AND CREDIT ORGANIZATIONS (Such as, Dun & Bradstreet, Standard and Poor's, etc.)

6. DESCRIBE ANY OUTSTANDING LIENS OR JUDGEMENTS

4. MOST RECENT CREDIT RATING

5. DOES PRICE APPEAR UNREALISTICALLY LOW?

a. DATE

b. BY

YES

NO (If Yes, explain in Section I NARRATIVE)

CATEGORY

1. CURRENT CONTRACT SALES (Backlog)

2. ANTICIPATED ADDITIONAL SALES

3. TOTALS

A. GOVERNMENT (Prime & Subcontractor)

B. COMMERCIAL

A. GOVERNMENT (Prime & Subcontractor)

B. COMMERCIAL

TOTAL

STANDARD FORM 1407 (REV. 1/2014) PAGE 3

8.2.1.4029.1.523496.503679 Standard Form 1407 - Pre-Award Survey of Prospective Contractor (Financial Capability)

GOVERNMENT FINANCING AT PRESENT. YES: 0

GOVERNMENT FINANCING AT PRESENT. NO: 0