ATTACHMENT_4_-_DETERMINATION_OF_RESPONSIBILITY.pdf

DETERMINATION OF RESPONSIBILITY

Solicitation No.: W912EP-12-T-0012

Contractor: ________________________________________________

The following information is provided to assist the contracting officer in determining whether or not the proposed contractor meets the general standards of responsibility enumerated at FAR 9.104-1 and DFARS 209.104-1.FAR 9.104-1 General Standards. To be determined responsible, a prospective contractor must --

(a) HAVE ADEQUATE FINANCIAL RESOURCES TO PERFORM THE CONTRACT, OR THE ABILITY TO OBTAIN THEM (SEE 9.104-3(b))

Banking References

Please provide letters from the banking references to confirm this information.

*1st bank's name: ______________________________________________ Telephone #: __________________________________________________ Address: ______________________________________________________ Person: _______________________________________________________ Title: _________________________________________________________ Length of time with bank: _____________________________________ Credit Rating: ________________________________________________ Number/type of accounts: ______________________________________ Amount in each account (# of figures): ________________________ Credit line:______________________ Secured/Unsecured Outstanding loans:_______________________ Secured/Unsecured Comments:

*2nd bank's name: ______________________________________________

Address: ______________________________________________________ Person: _______________________________________________________ Title: _________________________________________________________ Length of time with bank: _____________________________________ Credit Rating: ________________________________________________ Number/type of accounts: ______________________________________ Amount in each account (# of figures): ________________________ Credit line:______________________ Secured/Unsecured Outstanding loans:_______________________ Secured/Unsecured Comments:

*** Please provide letters from the banking references to confirm this information.

(b) BE ABLE TO COMPLY WITH THE REQUIRED OR PROPOSED DELIVERY OR PERFORMANCE

SCHEDULE, TAKING INTO CONSIDERATION ALL EXISTING COMMERCIAL AND GOVERNMENTAL

BUSINESS COMMITMENTS

(c) HAVE A SATISFACTORY PERFORMANCE RECORD (SEE 9.104-3(c)and Subpart 42.15)

(d) HAVE A SATISFACTORY RECORD OF INTEGRITY AND BUSINESS ETHICS

Trade References

*1st company: ___________________________________________________ Telephone #: __________________________________________________ Address: ______________________________________________________ Name: _________________________________________________________ Title: ________________________________________________________ Length of time with company: __________________________________ Credit line: __________________________________________________ Average monthly business: _____________________________________ High credit: __________________________________________________ Payment history: ______________________________________________ Takes discounts: ______________________________________________ Comments: _____________________________________________________

*2nd Company: ___________________________________________________

Address: ______________________________________________________ Name: _________________________________________________________ Title: ________________________________________________________ Length of time with company: __________________________________ Credit line: __________________________________________________ Average monthly business: _____________________________________ High credit: __________________________________________________ Payment history: ______________________________________________ Takes discounts: ______________________________________________ Comments: _____________________________________________________

Performance References *1st company: ___________________________________________________ Telephone #: __________________________________________________ Address: ______________________________________________________ Name: _________________________________________________________ Title: ________________________________________________________ Location and type of work: ____________________________________ Completed on time: ____________________________________________ On budget: ____________________________________________________ Quality of work: ______________________________________________ Management cooperative: _______________________________________ Any problems encountered: ______________________________________

*2nd company: ___________________________________________________ Telephone #: __________________________________________________ Address: ______________________________________________________ Name: _________________________________________________________ Title: ________________________________________________________ Location and type of work: ____________________________________ Completed on time: ____________________________________________ On budget: ____________________________________________________ Quality of work: ______________________________________________

Management cooperative: _______________________________________ Any problems encountered: ______________________________________

*3rd company: ___________________________________________________ Telephone #: __________________________________________________ Address: ______________________________________________________ Name: _________________________________________________________ Title: ________________________________________________________ Location and type of work: ____________________________________ Completed on time: ____________________________________________ On budget: ____________________________________________________ Quality of work: ______________________________________________ Management cooperative: _______________________________________ Any problems encountered: ______________________________________

(e) HAVE THE NECESSARY ORGANIZATION, EXPERIENCE, ACCOUNTING AND OPERATIONAL

CONTROLS, AND TECHNICAL SKILLS, OR THE ABILITY TO OBTAIN THEM (INCLUDING, AS

APPROPRIATE, SUCH ELEMENTS AS PRODUCTION CONTROL PROCEDURES, PROPERTY CONTROL

SYSTEMS, QUALITY ASSURANCE MEASURES, AND SAFETY PROGRAMS APPLICABLE TO

MATERIALS TO BE PRODUCED OR SERVICES TO BE PERFORMED BY THE PROSPECTIVE

CONTRACTOR AND SUBCONTRACTORS) (SEE 9.104-3(b))

(f) BE OTHERWISE QUALIFIED AND ELIGIBLE TO RECEIVE AN AWARD UNDER APPLICABLE LAWS

AND REGULATIONS