Financial Institution Reference Sheet.docx
DOCX document 13 KB Posted
- Attached to
- Fire Protection and Emergency Services
- Solicitation number
- FA465921R0002
About this file
This document contains a reference sheet template and information on a federal contract solicitation. The solicitation is for fire protection and emergency services at Cavalier Air Force Station in North Dakota. The contractor will provide all labor, tools, equipment, and materials to perform these services on a 24/7 basis in accordance with the performance work statement. The contract has a base period of November 1, 2021 to October 31, 2022 with four option periods of 12 months each, for a total potential period of performance from November 1, 2021 to October 31, 2026. The award will be made using best value tradeoff with past performance significantly more important than price. The requirement is set aside for small businesses with a NAICS code of 561990 and size standard of $12 million. Prospective offerors must register in SAM and submit any questions by April 21, 2021 to the contracting contacts provided.
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Other files
| File | Type | Posted |
|---|---|---|
| Financial Institution Reference Sheet v2.docx | DOCX document | |
| Solicitation Amendment - FA465921R00020002.pdf | ||
| Past Performance Questionnaire v2.docx | DOCX document | |
| Questions and Answers.pdf | ||
| Past Performance Questionnaire.docx | DOCX document | |
| Performance Work Statement 16 March 2021.pdf | ||
| CAFS FES CBA (dated 3 August 2017).pdf | ||
| Government Furnished Property and Equipment.xlsx | XLSX spreadsheet | |
| Solicitation FA465921R0002.pdf |
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Text version
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 institutions in regards to a determination of contractor responsibility as part of the evaluation for the solicitation: FA465921R0002, for Fire Protection and Emergency Services at Cavalier Air Force Station, ND. The top portion should be completed first, then sent to each financial institution for completion. Please have completed surveys returned directly from the financial institutions to Mrs. Carly Larson via email at carly.larson@us.af.mil.
TO BE FILLED OUT BY THE CONTRACTOR:
Company’s Name: _________________________________ Point of Contact (POC) Name: _______________________ POC Phone Number: _______________________________
INSTITUTION NAME: _____________________________
POC Name: _______________________________________ POC Title: ________________________________________ POC Phone Number: ________________________________
I give permission for the following information regarding my account(s) at your institution to be released to representatives of the 319th Contracting Squadron, Grand Forks Air Force Base, ND.
| ____________________________ | _________________________ | |
| 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 |
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