Fillable Printable Preaward Survey Of Prospective Contractor Financial Capability

Preaward Survey Of Prospective Contractor Financial Capability

PREAWARD SURVEY OF PROSPECTIVE

CONTRACTOR

FINANCIAL CAPABILITY

SERIAL NUMBER (For surveying activity use)

PROSPECTIVE CONTRACTOR

OMB Control Number: 9000-0011

Expiration Date: 6/30/2020

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork

Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The

OMB control number for this collection is 9000-0011. We estimate that it will take 24 hours to read the instructions, gather the facts, and answer the questions.

Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S.

General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

SECTION I - RECOMMENDATION

1. RECOMMENDED

3. NARRATIVE (Cite those sections of the report which substantiate the recommendation. Give any other backup information in this space or on an additional sheet, if necessary.)

a. COMPLETE AWARDb. PARTIAL AWARDc. NO AWARD

(Quantity:)

2. TOTAL OFFERED PRICE

4. SURVEY

MADE BY

5. SURVEY

REVIEWING

OFFICIAL

a. SIGNATUREb. TELEPHONE NUMBER

(Include area code)

c. DATE SIGNED

a. SIGNATUREb. TELEPHONE NUMBER

(Include area code)

c. DATE REVIEWED

IF CONTINUATION SHEETS

ATTACHED - MARK HERE

STANDARD FORM 1407 (REV. 1/2014)

Prescribed by GSA - FAR (48 CFR) 53.209-1(e)

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is usable.

SECTION II - GENERAL

SECTION III - BALANCE SHEET/PROFIT AND LOSS STATEMENT

SECTION IV - PROSPECTIVE CONTRACTOR'S FINANCIAL ARRANGEMENTS

SECTION V - GOVERNMENT FINANCIAL AID

3. FINANCIAL AID CURRENTLY OBTAINED FROM THE GOVERNMENT

4. LIST THE GOVERNMENT AGENCIES INVOLVED

5. SHOW THE APPLICABLE CONTRACT NUMBERS

Complete items below only if item a., is marked "YES."

PART A - LATEST BALANCE SHEET

3. FINANCIAL POSITION

5. RATIOS

PART B - LATEST PROFIT AND LOSS STATEMENT

1. TYPE OF COMPANY

2. YEAR ESTABLISHED:

CORPORATION

OTHER (Specify)

DIVISION

PARTNERSHIP

SUBSIDIARY

PROPRIETORSHIP

3. NAME AND ADDRESS OF:

a. PARENT COMPANY

b. SUBSIDIARIES

1. DATE2. FILED WITH

1. CURRENT PERIOD

PART C - OTHER

1. FISCAL YEAR ENDS (Date):

a. FROMb. TO

2. FILED WITH

a. Cash

b. Accounts Receivable

c. Inventory

d. Other Current Assets

e. Total Current Assets

f. Fixed Assets

g. Current Liabilities

h. Long Term Liabilities

i. Total Liabilities

j. Net Worth

4. WORKING CAPITAL (Current Assets less Current Liabilities)

a. CURRENT ASSETS

TO CURRENT

LIABILITIES

c. TOTAL LIABILITIES

TO NET WORTH

b. ACID TEST (Cash, temporary

investments held in lieu of cash

and current receivables to current

liabilities)

3. NET SALES

4. NET PROFITS

BEFORE TAXES

a. CURRENT PERIOD

b. First prior fiscal year

c. Second prior fiscal year

a. CURRENT PERIOD

b. First prior fiscal year

c. Second prior fiscal year

2. BALANCE SHEETS

AND PROFIT AND LOSS

STATEMENTS HAVE

BEEN CERTIFIED

a. THROUGH (Date)b. BY (Signature)

3. OTHER PERTINENT DATA

4. INDEPENDENT ANALYSIS OF FINANCIAL POSITION SUPPORTS THE STATEMENTS SHOWN IN ITEMS 1, 2, AND 3

2. EXPLAIN ANY "YES" ANSWERS TO ITEMS 1a, b, AND c.

YES

NO (If "NO", explain)

Mark "X" in appropriate column.

1. USE OF OWN RESOURCES

2. USE OF BANK CREDITS

3. OTHER (Specify)

YESNO

Mark "X" in appropriate column.

a. PROGRESS PAYMENT(S)

b. GUARANTEED LOAN

c. ADVANCE PAYMENTS

YESNO

1. TO BE REQUESTED IN CONNECTION WITH

PERFORMANCE OF PROPOSED CONTRACT

a. PROSPECTIVE

CONTRACTOR

RECEIVES

GOVERNMENT

FINANCING AT

PRESENT

YESNONO$

b. IS LIQUIDATION

CURRENT?

c. AMOUNT OF UNLIQUIDATED

PROGRESS PAYMENTS

OUTSTANDING

YES

DOLLAR AMOUNTS(a) AUTHORIZED

(b) IN USE

a. Guaranteed loans

b. Advance payments

STANDARD FORM 1407 (REV. 1/2014) PAGE 2

SECTION VI - BUSINESS AND FINANCIAL REPUTATION

SECTION VII - SALES (000'S) FOR NEXT SIX QUARTERS

1. COMMENTS OF PROSPECTIVE CONTRACTOR'S BANK

2. COMMENTS OF TRADE CREDITORS

3. COMMENTS AND REPORTS OF COMMERCIAL FINANCIAL SERVICES AND CREDIT ORGANIZATIONS (Such as, Dun & Bradstreet, Standard and Poor, etc.)

6. DESCRIBE ANY OUTSTANDING LIENS OR JUDGEMENTS

4. MOST RECENT

CREDIT RATING

5. DOES PRICE APPEAR UNREALISTICALLY LOW?

a. DATEb. BY

YES

NO (If Yes, explain in Section I NARRATIVE)