ATTACHMENT_A_FINANCIAL_QUESTIONAIRE.doc

EXHIBIT A

FINANCIAL QUESTIONNAIRE

(To be submitted by Offeror)

NAVFAC Far East, ROICC Camp Butler is currently considering award of a Navy contract to our firm. Prior to award, the Navy requests the financial information listed below with regard to our firm. In order to be responsive to the Navy’s needs it is requested that you complete this financial questionnaire with regard to our firm. Upon completion of the questionnaire it is requested that you place the completed questionnaire in a sealed envelope showing the return address of the financial institution and forward it to the offeror shown below. The requested information must be received by the contractor no later than _______________________ (date shall be inserted by the contractor).

Prospective Contractor for which information is being requested:

Name:

Address: _______________________________________________________

City/State/Zip: __________________________________________________

Telephone Number: ______________________________________________

Point of Contact: ________________________________________________

Signature of Prospective Contractor or Contractor Representative Requesting Financial Information

Name of Bank: ______________________________________

Address: _______________________________________________________

Phone: ________________________________________________________

1. How long has the Contractor been this client? ________________

2. This client has deposits in the amount of ¥____________

3. Does this client have outstanding loans? ____(Yes or No) If yes, what is the amount? ¥___________

4. What is the client’s line of credit? ¥____________ What is a current balance? ¥____________

5. Are you willing to grant additional monies to this client, if necessary? ____ (Yes or No) Name and Title of Person providing the above information

Signature of Person providing the above information

Please provide any additional comments that may help determine business and financial reputation and integrity of the prospective contractor on a separate sheet of paper. *SUBMIT THIS FORM WITH YOUR PROPOSAL ATTACHED TO A LATEST FINANCIAL STATEMENT (KESSAN HOKOKU SHO).