Form 3 - Financial Questionnaire.docx

Request for Proposal (RFP) Form 3 – Financial Questionnaire 3202600180 – BET Vending Multiple Locations Respondent name: ________________________ The Respondent must provide the following information. If more space is needed for the explanation, please attach additional page(s) as necessary:

a. Indicate if your company or any of its subsidiaries filed or met criteria for bankruptcy within the past five (5) years, if so, provide explanation.

b. Indicate if your firm is currently in default on any loan agreement or financial agreement institution, or other entity. If so, specify date(s), details, circumstances, and prospect resolution.

c. Identify if your company is currently for sale or involved in any transaction to expand or become acquired by another business entity during the next twelve (12) months following the Response Submission Deadline. If so, explain the impact both in organization and company director.

d. Ownership structure (e.g., corporation, partnership, LLC, or sole proprietorship), including any wholly-owned subsidiaries, affiliated companies, or joint ventures. (Please provide this information both in a narrative and as a graphical representation.)

1. If Respondent is an affiliate of, or has a joint venture or strategic alliance with, another company, Respondent must identify the percentage of ownership of each joint venture member or affiliate and the percentage of the parent company’s ownership. The entity performing the majority of the work under any Contract resulting from this Solicitation, throughout the duration of the Contract, must be the primary bidder.

2. Finally, Respondent must provide its proposed operating structure for the services requested under this Solicitation and which entities (i.e., parent company, affiliate, joint venture, subcontractor) will be performing the services;

e. The year the company was founded and/or incorporated. If incorporated, please indicate the state where the company is incorporated and the date of incorporation;

f. The location of company headquarters and any field office(s) that may provide services for any resulting Contract under this Solicitation;

g. The number of employees in the company, both locally and nationally, and the location(s) from which employees will be assigned to TWC’s project; and

h. Indicate whether the company has ever been in contract with any Texas state agency. If “Yes,” specify the contract term, for what duties, and with which agency.