Financial Questionnaire_P1241.pdf

Financial Questionnaire, Page 1 of 2 (Rev 7/2020)

FINANCIAL QUESTIONNAIRE

N62473-25-R-3443

(To be completed and submitted by the Offeror’s Financial Institution)

Naval Facilities Engineering 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 points of contact: Lauren Steigerwald via email at lauren.e.steigerwald.civ@us.navy.mil and Victor Mariscal via email at victor.m.mariscal.civ@us.navy.mil by the due date and time specified in the solicitation. 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? 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?

Name and Title of person providing the above information:

Signature of person providing the above information mailto:lauren.e.steigerwald.civ@us.navy.mil mailto:victor.m.mariscal.civ@us.navy.mil

Financial Questionnaire, Page 2 of 2 (Rev 7/2020)

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