FINANCIAL_CAPACITY_FORM.pdf

599 KB Posted

Attached to
VoIP Phones
Solicitation number
2022-14
Issued by
Essex County, Kentucky

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Written by GovTribe AI ·

The document is a Financial Capacity Form provided by Lextran, a financial institution form designed to verify a company's financial standing. The form is intended to be completed entirely by a financial institution representative to demonstrate the financial stability of a company applying for a contract or bid opportunity. The form emphasizes confidentiality, stating that all financial information is not subject to open records requests.

The form requires the financial institution representative to confirm the company's customer status, including the duration of their relationship, and to attest to the company's account standing. Two checkboxes are provided: one to indicate that all accounts remain in good standing, and another to acknowledge that one or more accounts are not in good standing. The form includes spaces for the date, an authorized signature, the representative's printed name, and their professional title, allowing for official verification of the company's financial status.

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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 .