PREAWARD SURVEY OF PROSPECTIVE CONTRACTOR FINANCIAL CAPABILITY

SERIAL NO. (For surveying activity use)

OMB No.:9000-0011
Expires: 09/30/91

PROSPECTIVE CONTRACTOR

Public reporting burden for this collection of information is estimated to average 24 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the FAR Secretariat (VRS), Office Federal Acquisition and Regulatory Policy, GSA, Washington, DC 20405; and to the Office of Management and Budget, Paperwork Reduction Project (9000-0011), Washington, DC 20503.

SECTION I - RECOMMENDATION

1.  RECOMMENDED
 a. COMPLETE AWARD          b. PARTIAL AWARD (Quantity: ___________ )           c. NO AWARD

2.  TOTAL OFFERED PRICE

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.)

IF CONTINUATION SHEETS
ATTACHED - MARK HERE 

4. SURVEY MADE BY

a. SIGNATURE

b.  TELEPHONE NUMBER (Include area code)

c.  DATE SIGNED

5. SURVEY REVIEWING OFFICIAL

a. SIGNATURE

b.  TELEPHONE NUMBER (Include area code)

d.  DATE REVIEWED

SECTION II - GENERAL

1. TYPE OF COMPANY

3. NAME AND ADDRESS OF:

      CORPORATION

  PARTNERSHIP

a. PARENT CO.

      SUBSIDIARY

  DIVISION

      PROPRIETORSHIP

  OTHER (Specify)

b. SUBSIDIARIES

2. YEAR ESTABLISHED:

SECTION III - BALANCE SHEET/PROFIT AND LOSS STATEMENT

PART A - LATEST BALANCE SHEET

PART B - LATEST PROFIT AND LOSS STATEMENT

1. DATE

2. FILED WITH

1. CURRENT  PERIOD

2. FILED WITH

a. FROM

b. TO

3. FINANCIAL POSITION

a. Cash

$

3. NET SALES

a. CURRENT PERIOD

$

b. Accounts Receivable

b. First prior fiscal year

c. Inventory

c. Second prior fiscal year

d. Other Current Assets

e. Total Current Assets

4. NET PROFITS BEFORE TAXES

a. CURRENT PERIOD

$

f. Fixed Assets

b. First prior fiscal year

g. Current Liabilities

c. Second prior fiscal year

h. Long Term Liabilities

PART C - OTHER

i. Total Liabilities

1. FISCAL YEAR ENDS (Date).

j. Net Worth

2. BALANCE SHEETS AND PROFIT AND LOSS STATEMENTS HAVE BEEN CERTIFIED

a. THROUGH (Date)

►

b. BY (Signature)

4. WORKING CAPITAL (Current Assets less Current Liabilities)

5.  RATIOS

3. OTHER PERTINENT DATA

a. CURRENT ASSETS TO CURRENT LIABILITIES

b. ACID TEST (Cash, temporary investments held in lieu of cash and current receivables to current liabilities)

c. TOTAL LIABILITIES TO NET WORTH

SECTION IV - PROSPECTIVE CONTRACTOR'S FINANCIAL ARRANGEMENTS

Mark "X" in appropriate column.

YES

NO

1. USE OF OWN RESOURCES

4. INDEPENDENT ANALYSIS OF FINANCIAL POSITION SUPPORTS THE STATEMENTS SHOWN IN ITEMS 1, 2, AND 3             YES     NO  (If "NO", explain)

2. USE OF BANK CREDITS

3. OTHER (Specify)

SECTION V - GOVERNMENT FINANCIAL AID

1. TO BE REQUESTED IN CONNECTION WITH PERFORMANCE OF PROPOSED CONTRACT

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

Mark "X" in appropriate column.

YES

NO

a. PROGRESS PAYMENT(S)

b. GUARANTEED LOAN

c. ADVANCE PAYMENTS

3. FINANCIAL AID  CURRENTLY OBTAINED  FROM  THE GOVERNMENT

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

a. PROSPECTIVE CONTRACTOR RECEIVES GOVERNMENT FINANCING AT PRESENT

b. IS LIQUIDATION CURRENT?

c. AMOUNT OF UNLIQUIDATED PROGRESS PAYMENTS OUTSTANDING

DOLLAR AMOUNTS

(a) AUTHORIZED

(b) IN USE

a. Guaranteed loans

$

$

 YES     NO

 YES        NO

$

b. Advance payments

$

$

4. LIST THE GOVERNMENT AGENCIES  INVOLVED

5. SHOW THE APPLICABLE CONTRACT NOS.

SECTION VI - BUSINESS AND FINANCIAL REPUTATION

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.)

4. MOST RECENT CREDIT RATING

►

a. DATE

b. BY

5. DOES PRICE APPEAR UNREALISTICALLY LOW?

    YES              NO  (If Yes, explain in Section / NARRATIVE)

6. DESCRIBE ANY OUTSTANDING LIENS OR JUDGMENTS

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

CATEGORY

1

2

3

4

5

6

TOTAL

1. CURRENT CONTRACT SALES (Backlog)

$

$

$

$

$

$

$

A. GOVERNMENT (Prime & Subcontractor)

B. COMMERCIAL

2. ANTICIPATED ADDITIONAL SALES

A. GOVERNMENT (Prime & Subcontractor)

B. COMMERCIAL

3. TOTALS

STANDARD FORM 1407 (REV. 9-88)
Prescribed by GSA – FAR (48 CFR) 53.209-1(e)