Financial Questionnaire Revised 11-18-2021.doc

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IDIQ MACC SMALL BUSINESS SET-ASIDE FOR NEW CONSTRUCTION, RENOVATION, AND REPAIR OF DRY UTILITIES CONSTRUCTION PROJECTS AT VARIOUS GOVERNMENT INSTALLATIONS IN CA, AZ, NV, UT, CO, AND NM
Solicitation number
N6247321R1216
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FINANCIAL QUESTIONNAIRE

N62473-21-R-1216

Naval Facilities Engineering Systems Command Southwest, San Diego, California 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. Please send the completed questionnaire via email directly to the Navy point of contact: Michelle Sanders at michelle.sanders@navy.mil no later than Month DD, 202Y. Please utilize this form to submit the requested information. Links to websites and/or files with .zip file extensions may not be accepted by the Navy.

Prospective Contractor for which information is being requested:

Name:
Address:
Point of Contact::
Phone Number:
Email:

Signature of Prospective Contractor or Contractor Representative Requesting Financial Information

Name of Financial Institution:
Address:
Phone Number:
Type of Account:
Average Balance Figure:

Does the Contractor have a line of credit? FORMCHECKBOX Yes FORMCHECKBOX No

What is the limitation?
Remaining Balance:

What is the Contractor’s relationship with the bank?

FORMCHECKBOX

Outstanding FORMCHECKBOX Satisfactory FORMCHECKBOX Other (explain):

How long has the Contractor been a client?
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 the business and financial reputation and integrity of the prospective contractor on a separate sheet.

Financial Questionnaire, Page 1 of 1 (Rev 11/21)

File details come from the government source that posted it. Updated .