EXHIBIT A _ FINANCIAL QUESTIONNAIRE.pdf
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- Solicitation number
- N62473-21-R0020
About this file
This financial questionnaire is to be completed by an offeror's financial institution and submitted under Tab 3 of the offeror's price proposal for a Navy contract. The prospective contractor must request its financial institution provide information including the account type and average balance, whether the contractor has a line of credit and its limitations/remaining balance, how long the contractor has been a client, and the nature of its relationship with the bank. The completed financial questionnaire must be sealed in an envelope displaying the financial institution's return address and forwarded to the prospective contractor no later than the specified date.
This acquisition will result in the award of an 8(a) set-aside Indefinite Delivery Indefinite Quantity (IDIQ) Firm Fixed Price Multiple Award Service Contract for the Naval Facilities Engineering Command Southwest Area of Responsibility, including Arizona, California, Colorado, New Mexico, Nevada, and Utah. The successful offerors must be able to perform multiple task orders in multiple locations simultaneously. The proposed initial task order includes recurring services and IDIQ non-recurring work for facility investment, pest control, integrated solid waste management, and grounds maintenance/landscaping at Marine Corps Base Camp Pendleton, California.
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Text version
MULTI-FUNCTION MASC N62473-21-R-0020
NAVFAC SW AOR SOURCE SELECTION PLAN
REV JAN 2018
SOURCE SELECTION SENSITIVE INFORMATION
DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY
EXHIBIT A
FINANCIAL QUESTIONNAIRE
(To be completed by Financial Institution and submitted by Offeror under Tab 3 of the Price Proposal)
NAVFAC Southwest is currently considering award of a Navy contract to this firm. Prior to award, the Navy requests the financial information listed below with regard to this firm. In order to be responsive to the Navy’s needs, it is requested that you complete this financial questionnaire with regard to this 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 ___________________________
Prospective Contractor for which information is being requested:
Name: ______________________________________________________________ Address: ____________________________________________________________ City/State/Zip: ________________________________________________________ Phone Number: _______________________________________________________ Point of Contact: ______________________________________________________
Signature of Prospective Contractor or Contractor Representative Requesting Financial Information
Name of Financial Institution: ______________________________________________________ Address: _______________________________________________________________________ Phone Number: _________________________________________________________ Account Number: __________________________________________ Type of Account: __________________________________________ Average Balance Figure: ___________________________________________ Does the Contractor have a line of credit? Yes No
What is the limitation? __________________ Remaining balance: ______________________
What is the Contractor’s relationship with the bank:
Outstanding Satisfactory Other (explain): ________________________________
How long has the Contractor been a client? _______________________________
Signature of person providing the above information
Print Name and Title of person providing the above information
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