Attachment_12__Responsibility_Questionnaire_Financial.docx
DOCX document 25 KB Posted
- Solicitation number
- ID07170051
- Issued by
-
GSA Federal Acquisition Service
About this file
Attachment 12 Responsibility Questionnaire Financial. This document must be completed and submitted with your proposal on the date of closing.
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Text version
RESPONSIBILITY QUESTIONNAIRE – FINANCIAL ATTCHMENT 12
ID07170051
Training System Support Center (TSSC)/(AAJTS)
1. Name of Contractor to whom the following information is applicable:
2. Name of Financial Institution:
3. Address of Financial Institution:
4. How long has the firm been a commercial customer of your bank?
5. What is the type of account and its average *balance? (continue on separate sheet if necessary)
| ☐Checking $ | ☐Checking $ | ||||
| ☐Savings $ | ☐Savings $ | ||||
| ☐CD $ | ☐CD $ | ||||
| ☐Money Market $ | ☐Money Market $ | ||||
| ☐Other | $ | ||||
| (SPECIFY TYPE) |
6. Does the company maintain a loan balance at the bank? In what amount?
☐YES ☐NO $
7. Does the company maintain an unsecured line of credit at the bank? In what amount?
☐YES ☐NO $
8. What company’s standing with your bank?
☐Outstanding ☐Excellent ☐Satisfactory ☐Poor ☐Unsatisfactory ☐Other Explain on separate sheet of paper
9. COMMENTS:
I certify that the above information is correct as of (Date)
SIGNATURE:
BY:
(Print name/tile of authorized representative)
DATE:
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