Attachment_11_Financial_Information_Questionnaire.doc

ICODES-V7

SOLICITATION: HTC711-14-R-D006

ATTACHMENT 11

FINANCIAL INFORMATION QUESTIONNAIRE

Information regarding the following items shall be furnished in sufficient detail to allow a full and complete evaluation.

1. __________________________________________________

(Contractor)

(Address)

(Telephone)

(Point of Contact)

2. Date Company Organized:_____________________________

3. Attach a current organizational chart.

4. Name and address of banking facility, point of contact, email address, and telephone number.

(Bank Name)

(Address)

(Telephone)

(Point of Contact)

5. Attach a copy of the written letter to your financial institution(s) authorizing the financial institution to discuss the offeror’s financial information with the Contracting Officer or designated representative.

6. Publicly traded companies may submit a copy of the U.S. Securities and Exchange Commission Form 10-K instead of the information required by this form.

Source Selection Information – See FAR 2.101 and 3.104