Exhibit E - Financial Questionnaire.docx

IDIQ Roofing – EDWOSB set-aside, N62473-14-R-2201 – Exhibit E – Financial Questionnaire

EXHIBIT E - FINANCIAL QUESTIONNAIRE

Solicitation N62473-14-R-2201 (To be submitted by Offeror)

MCIWEST, ROICC Camp Pendleton, CA is currently requesting proposals for a Navy contract for IDIQ Roofing Construction Projects. As part of the proposal submission requirements, 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 Prospective Contractor shown below. The requested information must be received by the contractor no later than __________________________ (Prospective Contractor is responsible to fill in date by which your response is needed) in order to meet the proposal submission deadline.

Prospective Contractor for which information is being requested:

Signature of Prospective Contractor or Contractor Representative Requesting Financial Information:

Name of Financial Institution: ______________________________________________________ Address: __________________________________________________________________________ Phone Number: _________________________________________________________

a. Account(s):

Checking: Date Opened:_______________ *Average Balance :___________________________

Savings: Date Opened: _______________ *Average Balance: ___________________________

*Please note that the account balances may be provided by indicating a range, or only the number of figures, e.g., low five figures, high four figures, etc.

Loan(s): Date Opened: _______________ Original Amount:____________________________

Current Balance:____________________

b. Does the Contractor have a line of credit? |_| Yes |_| No

Customer’s Line of Credit: ___________________________ Expiration Date:______________________

Unused Balance: _________________

c. Would you be willing to grant this customer a Line of Credit Increase, or loan, if required?

|_| Yes |_| No

What is the Contractor's relationship with the bank:

|_| Outstanding |_| Satisfactory |_| Other (explain): ________________________________________________

How long has the Contractor been a client? ___________________________________________________________

Name of Person providing the above information

Signature and Title of Person providing the above information

Phone Number 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.

Revised 19 July 2011 1 N62473-12-R-3002

SOURCE SELECTION SENSITIVE INFORMATION

DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY