FINANCIAL_CAPACITY_FORM.pdf

PDF 599 KB Posted

Attached to
Environmental Services
Solicitation number
2022-13
Issued by
Essex County, Kentucky

About this file

This is a Financial Capacity Form designed to verify the financial standing of bidding companies for state and local contract opportunities. The form requires completion by an authorized representative of a financial institution and serves as a requirement for proposals to be deemed responsive. The form captures essential financial verification data, including the name of the financial institution, the company name, and the duration of the company's customer relationship with the institution. The form requires the financial institution representative to certify whether all company accounts remain in good standing status or whether one or more accounts are not in good standing, with authorization provided through signature, printed name, title, and date fields.

All financial information submitted through this form is designated as confidential and is explicitly not subject to open records requests, protecting the sensitive financial data of bidding entities. The form contains checkboxes for account status verification and fields for multiple authorized financial representatives, allowing for comprehensive financial documentation from the bidding company's banking institution. This form functions as a financial qualification screening tool to ensure that only financially viable contractors are considered for contract awards and that bidders meet minimum financial capability standards established by the procuring jurisdiction.

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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 .