FINANCIAL_CAPACITY_FORM.pdf
PDF 599 KB Posted
- Attached to
- Environmental Services
- Solicitation number
- 2022-13
- Issued by
- Essex County, Kentucky
About this file
The document is a Financial Capacity Form issued by Lextran, a Kentucky-based organization, designed to verify a company's financial standing with a financial institution. The form requires a financial representative to confirm the company's customer status, account standing, and provide essential details such as the institution's name, customer name, and the duration of their banking relationship. Respondents must indicate whether all accounts are in good standing or if there are any accounts not in good standing.
The form is confidential and not subject to open records requests, emphasizing the sensitive nature of the financial information being collected. It is structured with blank fields for the financial institution's name, the company's name, the month and year of the banking relationship, the representative's signature, printed name, and title. The primary purpose appears to be a standard due diligence document for a procurement process, likely related to the environmental services contract described in the accompanying government file description for Lextran in Fayette County, Kentucky.
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Text version
FINANCIAL CAPACITY FORM
This form is to be filled out in its entirety by a financial institution representative for the proposal to be deemed responsive. All financial information is confidential and is not subject to open records requests.
As an authorized financial representative of ___________________________________________, all records Name of Financial Institution show that ____________________________________________ is an existing customer and has been since Name of Company
Month/Year
Please mark the correct statement as it applies to the company listed above:
All accounts remain in good standing status.
One or more accounts are not in good standing.
DATE: ___________________________________________________________
AUTHORIZED SIGNATURE: _______________________________________
PRINT NAME: ___________________________________________________
TITLE: ___________________________________________________________
| As an authorized financial representative of: |
| show that: |
| undefined: |
| DATE: |
| PRINT NAME: |
| TITLE: |
| Check Box3: Off |
| Check Box4: Off |
File details come from the government source that posted it. Updated .