Contract Identification: [indicate [insert [insert [insert amount] complete contract name, number, and year] percentage] any other identification] Name of Employer: [insert full name] Address of Employer: [insert street/city/country] Matter in dispute: [indicate main issues in dispute] Party who initiated the dispute: [indicate “Employer” or “Contractor”] Status of dispute: [Indicate if it is being treated by the Adjudicator, under Arbitration or being dealt with by the Judiciary] Form FIN 3.1 – Financial Situation and Performance following table shall be filled in for the Applicant and for each member of a Joint Venture] [The Applicant’s Name: Date: [insert full name] [insert day, month, and year] Applicant’s Party Name:[insert full name] ICB No. and title: [insert ICB number and title] Page of pages [insert page number] [insert total number] 1. Financial data Type of Financial Historic information for previous (3) years, information in (amount in currency, currency, exchange rate*, USD (currency) equivalent) Year 1 Year 2 Year 3 Year4 Year 5 Statement of Financial Position (Information from Balance Sheet) Total Assets (TA) Total Liabilities (TL) Total Equity/Net Worth (NW) Current Assets (CA)
[insert year] [insert percentage] Contract Identification: [indicate complete contract name, number, and any other identification] Name of Employer: [insert full name] Address of Employer: [insert street/city/country] Matter in dispute: [indicate main issues in dispute] Party who initiated the dispute: [indicate “Employer” or “Contractor”] Status of dispute: [Indicate if it is being treated by the Adjudicator, under Arbitration or being dealt with by the Judiciary] [insert amount] Form FIN – 3.1 Financial Situation and Performance [The following table shall be filled in for the Applicant and for each member of a Joint Venture] Applicant’s Name: [insert full name] Date: [insert day, month, and year] Applicant’s Party Name:[insert full name] ICB No. and title: [insert ICB number and title] Page [insert page number] of [insert total number] pages 1. Financial data Type of Financial information in (currency) Historic information for previous (3) years, (amount in currency, currency, exchange rate*, USD equivalent) Year 1 Year 2 Year 3 Year4 Year 5 Statement of Financial Position (Information from Balance Sheet) Total Assets (TA) Total Liabilities (TL) Total Equity/Net Worth (NW) Current Assets (CA)