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pdfNPS Form 10-359B (Rev. 12/2019)
National Park Service
OFFEROR FINANCIAL STATEMENTS AND PROJECTIONS
SMALL CONTRACTS
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
PROPOSAL PACKAGE
CC-XXXX000-XX
Financial Statements
Complete the appropriate Financial Statements as described below:
The Service needs this information to verify there are enough funds available to be able to pay the required expenses to operate the
Draft Contract and satisfy any other existing debt. If the Offeror’s total debts exceed current assets, provide a narrative explaining how
these debts will be paid.
Financial Statements include both an Income Statement and a Balance Sheet. An Income Statement lists all of your income and
expenses as of the last day of your most recent fiscal year. A Balance Sheet lists everything that you own and everything that you owe
as of a certain date.
By signing the Offeror’s Transmittal Letter, you certify that the information you provide is complete, true, and correct.
If an Offeror is not yet formed, each Offeror-Guarantor should submit the appropriate Financial Statements as set forth below.
The Service requires all existing business entities to submit Business Financial Statements.
Provide, at a minimum, an audited or reviewed (i) Income Statement for the two most recent fiscal years and (ii) Balance Sheets (1) for
the most recent fiscal year and (2) as of the end of the most recent month prior to the submission of your proposal. Business Financial
Statements should reflect the entity’s business as a whole, including all operations both inside and outside of the Area.
If the entity does not have audited or reviewed Financial Statements, complete the Most Recent Fiscal Year Balance Sheet (Table 1),
the Most Recent Month Balance Sheet (Table 2), and the Historical Income Statement (Table 3) provided below.
The Service requires Sole Proprietors to submit Personal Financial Statements.
Complete the Personal Financial Statements (Table 4) below.
Notes to Offeror and/or Offeror-Guarantor:
In the event the Offeror is not yet in existence, submit financial statements for each Offeror-Guarantor. Submit Business Financial
Statements if the Offeror-Guarantor is a business entity. Submit Personal Financial Statements if the Offeror-Guarantor(s) is an
individual.
RECORDS RETENTION. TEMPORARY. Destroy/Delete 3 years after closure. (NPS Records Schedule, Commercial Visitor Services,
(Item 5D) (N1-79-08-4))
Page 1 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
Table 1: Business Financial Statement - Most Recent Fiscal Year Balance Sheet
For Fiscal Year Ending: _________________
Business Financial Statement- Most Recent Fiscal Year Balance Sheet
(Principal Selection Factor 4 - Subfactor 4(a))
1
Cash in Bank
$
2
Accounts Receivable
$
3
Inventory
$
4
Other Current Assets (Describe)
$
5
Total Current Assets (add lines 1-4)
$
6
Personal Property (Equipment) Items
$
7
Other Fixed Assets (Describe)
$
8
(LESS Accumulated Depreciation)
$
9
Total Fixed Assets (add lines 6-7, minus line 8)
$
10
Total Assets (add lines 5 & 9)
$
11
Accounts Payable
$
12
Bank Loans Outstanding
$
13
Loans due to Owners
$
14
Other Current Liabilities (Describe)
$
15
Total Current Liabilities (add lines 11-14)
16
Long-Term Liabilities (Describe)
$
17
Total Liabilities (add lines 15 and 16)
$
18
Total Net Worth (line 10 minus line 17)
$
Describe the information in lines 4, 7, 14 & 16 below:
Table 2: Business Financial Statement - Most Recent Month Balance Sheet
Page 2 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
For Month Ending: _________________
Business Financial Statement- Most Recent Month Balance Sheet
(Principal Selection Factor 4 - Subfactor 4(a))
1
Cash in Bank
$
2
Accounts Receivable
$
3
Inventory
$
4
Other Current Assets (Describe)
$
5
Total Current Assets (add lines 1-4)
$
6
Personal Property (Equipment) Items
$
7
Other Fixed Assets (Describe)
$
8
(LESS Accumulated Depreciation)
$
9
Total Fixed Assets (add lines 6-7, minus line 8)
$
10
Total Assets (add lines 5 & 9)
$
11
Accounts Payable
$
12
Bank Loans Outstanding
$
13
Loans due to Owners
$
14
Other Current Liabilities (Describe)
$
15
Total Current Liabilities (add lines 11-14)
16
Long-Term Liabilities (Describe)
$
17
Total Liabilities (add lines 15 and 16)
$
18
Total Net Worth (line 10 minus line 17)
$
Describe the information in lines 4, 7, 14 & 16 below:
Table 3: Business Financial Statement - Historical Income Statement
Page 3 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
Historical Income Statement
(Principal Selection Factor 4 - Subfactor 4(a))
1
Some lines may not be used, place "N/A" in these lines.
Include revenues and expenses related to the business as a whole,
including any operations both inside and outside of the park.
Year 1
Revenues
1a Revenue Source 1 _____________________
1b Revenue Source 2 _____________________
1c Revenue Source 3 _____________________
1d Revenue Source 4 _____________________
2
Total Revenues (add lines 1a-1d)
Cost of Sales
3
4
Total Cost of Sales
5
Gross Profit (line 2 minus line 4)
6
Direct Expenses
6a Salaries and Wages
6b Payroll Taxes and Benefits
6c Operating Supplies
6d Car and Truck Expenses
6e Other Direct Expense 1 __________________
6f Other Direct Expense 2 __________________
7
Total Direct Expenses (add lines 6a-6f)
8
Undistributed Expenses
8a Administrative and General
8b Marketing (Advertising)
8c Utilities
8d Repair and Maintenance
8e Other Undistributed Expense 1 ____________
8f Other Undistributed Expense 2 ____________
9
Total Undistributed Expenses (add lines 8a-8f)
Fixed Expenses
10
10a Insurance
10b NPS Franchise Fee (if applicable)
10c Other Fixed Expense 1 __________________
10d Other Fixed Expense 2 __________________
11
Total Fixed Expenses (add lines 10a – 10d)
Total direct, undistributed and fixed expenses (add lines 7, 9 and
12
11)
13
EBITDA* (Line 5 minus line 12)
14
Depreciation and Amortization
15
Interest
Net Income Before Income Taxes
16
(Line 13, minus lines 14 & 15)
*Earnings before Interest, Taxes, Depreciation and Amortization
Year 2
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Page 4 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
Table 4: Personal Financial Statement
Personal Financial Statement
(Principal Selection Factor 4 - Subfactor 4(a))
Name:
As of Date:
% Ownership:
1
Cash in Bank
$
2
IRA and Other Retirement Accounts
$
3
Stocks & Bonds in Taxable Accounts
$
4
Real Estate
$
5
Accounts and Loans Receivable
$
6
Life Insurance (Cash Surrender Value Only)
$
7
Automobile (Present Value Only)
$
8
Other Personal Assets (Describe)
$
9
Total Assets (add lines 1-8)
$
10
Accounts Payable
$
11
Bank Loans Outstanding
$
12
Mortgage Loans Outstanding
$
13
Other Loans Outstanding (Describe)
$
14
Unpaid Tax Liability
$
15
Other Liabilities (Describe)
$
16
Total Liabilities (add lines 10-14)
$
17
Total Net Worth (add lines 9 and 16)
$
18
Salary
$
19
Investment Income
$
20
Other Income (Describe)
$
21
Total Income (add lines 17-19)
$
22
Endorsements or Guarantees
$
23
Other Contingent Liabilities (Describe)
$
24
Total Contingent Liabilities (add lines 22-23)
Describe the information in lines 8, 13, 15, 20 & 23 below:
$
Page 5 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
Personal Property
Using Table 5 below, list all currently owned personal property with monetary value equal to or exceeding [Insert $ amount] that you will
use for your operations inside of the Park and provide an estimate of its current value. Unlike Subfactor 4a, do not include any
personal property for your operations outside of the Park.
Using Table 5 below, list all of the personal property with monetary value equal to or exceeding [Insert $ amount] that you will intend to
acquire to use for this.
Table 5: Personal Property to be used in the Draft Contract
Personal Property to be used in the Draft Contract
(Principal Selection Factor 4 - Subfactor 4(b))
Personal Property
Quantity
Total Value of Currently Owned Personal Property
Personal Property
Quantity
Total Value of Personal Property Investment
$
$
$
$
$
Value of Currently Owned
Personal Property
Value of Personal
Property that will be Acquired
Prior to Operation
$
$
$
$
$
Page 6 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
Start-Up Costs
Estimate the start-up costs needed to begin operating the business (within the Park only) and use those estimates to complete the
Table 6 below. Only provide estimates for those items you need to acquire in order to begin operating. Do not include costs
for items you already own. For working capital (cash), estimate the amount of cash you will need to have available after purchasing
the other items (describe) in order to begin operating the business. For example, working capital would include salaries and rent you
will pay before you generate income from the operations in the Park.
The total “Value of Personal Property Investment that will be Acquired Prior to Operation” that you listed in the previous table should be
equal to the amount you list for Personal Property in this table.
Table 6: Start-Up Costs
Estimate of Investment Required to Begin Operations in the Draft Contract
(Principal Selection Factor 4 - Subfactor 4(b))
Acquisition/Investment Category
Acquisition/Investment Amount
Personal Property (Equipment)
$
Merchandise (Inventory)
$
Supplies
$
Working Capital (Cash)
$
Other (Describe)
$
Total Funds Needed
Describe “Other” investment listed in the table:
$
Page 7 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
Operating Projections
a)
Based on the condition of your personal property provided or purchased for the operation, attach a list of items using Table 7,
that you will need to replace during the term of the Draft Contract. Include the anticipated year for the expenditure, the quantity
of item(s) to be replaced, the description of the item(s), the approximate total value of the replacement, and how you plan to
pay for the personal property replacement. (For example, cash, bank loan etc.).
If your projected expenditures for personal property investments exceeds [Insert $ amount], provide an explanation of how you will fund
the investment.
If you will not need to replace personal property during the term of the Draft Contract, explain your reasoning.
Add or remove rows for years as needed in Table 7.
Table 7: Additional Personal Property Investments
Additional Personal Property Investments during the term of the Draft Contract
(Principal Selection Factor 4 - Subfactor 4(b))
Anticipated Year
of Expenditure
Quantity
Capitalized Personal Property (Equipment) Items
Total Value
How will you fund
the investment?
Year 1
Year 1
Year 2
Year 2
Year 3
Year 3
Year 4
Year 4
Year 5
Year 5
Year 6
Year 6
Year 7
Year 7
Year 8
Year 8
Year 9
Year 9
Year 10
Year 10
b)
Demonstrate that your proposal is financially feasible and that you will have a reasonable opportunity to make a profit from
your business while carrying out the terms and conditions of the Draft Contract by completing the following Prospective
Income Statement, Table 8.
•
Estimate the amount of income and expenses for the proposed operation for the first year of operation. We included
blank lines on the prospective income statement for your estimates for expense categories we did not list. Describe
those categories on the blank lines.
Page 8 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
•
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
Include only revenues and expenses related to the services required and authorized by the Draft Contract inside the
Park. Do not include other services you may provide outside the Park.
Fully explain the assumptions on which you base your projections and provide sufficient details so we fully understand
your assumptions. Provide revenue estimates by department, if applicable. If the projections show significantly increased
revenues from the projections provided in the prospectus, provide a full explanation of the changes.
Note to Offeror: If you are not familiar with making these types of projections, you should consult an accountant or business
advisor.
Additional Instructions for completing the Prospective Income Statement on the next page:
Line 1:
Line 8a:
Line 10a:
Line 13:
You must base the revenue projections on the current NPS approved rate schedule (see Appendix [ ]). If applicable,
show revenues by departments (separate revenue activities - e.g., guide services, gift sales, snack bar revenue, etc.).
Administrative and General includes the costs of managing the business and may include items such as: credit card
commissions; legal and accounting fees; travel; meals and entertainment; postage and printing; professional training;
telecommunications expenses; etc.
Insurance: As required in Exhibit [ ] of the Draft Contract
Earnings before Interest, Taxes, Depreciation and Amortization
Page 9 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
Table 8: Prospective Income Statement
1
2
3
4
5
6
7
8
1a
1b
1c
1d
6a
6b
6c
6d
6e
6f
8a
8b
8c
8d
8e
8f
9
10
10a
10b
10c
10d
11
12
13
14
15
16
Prospective Income Statement
(Principal Selection Factor 4 - Subfactor 4(b))
If a line is marked with an asterisk, see additional notes on the previous page.
Some lines may not be used, place "N/A" in these lines.
Include only revenues and expenses related to the services required and authorized by the Draft
Contract inside the park in your prospective income statement. Do not include other services
you provide outside the park. This is unlike the Income Statement you provided in Subfactor 4(a).
Year 1
Assumptions
Revenues*
Revenue Source 1 _____________________
$
Revenue Source 2 _____________________
$
Revenue Source 3 _____________________
$
Revenue Source 4 _____________________
$
Total Revenues (add lines 1a-1d)
$
Cost of Sales
Total Cost of Sales
$
Gross Profit (Line 2 minus line 4)
$
Direct Expenses
Salaries and Wages
$
Payroll Taxes and Benefits
$
Operating Supplies
$
Car and Truck Expenses
$
Other Direct Expense 1 __________________
$
Other Direct Expense 2 __________________
$
Total Direct Expenses (add lines 6a-6f)
$
Undistributed Expenses
Administrative and General*
$
Marketing (Advertising)
$
Utilities
$
Repair and Maintenance
$
Other Undistributed Expense 1 ____________
$
Other Undistributed Expense 2 ____________
$
Total Undistributed Expenses (add lines 8a-8f)
$
Fixed Expenses
Insurance*
$
NPS Franchise Fee
$
Other Fixed Expense 1 __________________
$
Other Fixed Expense 2 __________________
$
Total Fixed Expenses (add lines 10a-10d)
$
Total direct, undistributed and fixed expenses (add lines 7, 9 and 11)
EBITDA* (Line 5 minus line 12)
$
Depreciation and Amortization
$
Interest
$
Net Income Before Income Taxes
$
(Line 13, minus lines 14 & 15)
Page 10 of 11
NPS Form 10-359B (Rev. 12/2019)
National Park Service
OMB Control No. 1024-0029
Expiration Date: XX/XX/XXXX
NOTICES
PRIVACY ACT STATEMENT
Authority: 16 U.S.C. 5966, Commercial Use Authorizations.
Purpose: The purposes of the system are (1) to assist NPS employees in managing the NPS Commercial Services program allowing
commercial uses within a unit of the National Park System to ensure that business activities are conducted in a manner that complies
with Federal laws and regulations; (2) to monitor resources that are or may be affected by the authorized commercial uses within a unit
of the National Park System; (3) to track applicants and holders of commercial use authorizations who are planning to conduct or are
conducting business within units of the National Park System; and (4) to provide to the public the description and contact information for
businesses that provide services in national parks.
Routine Uses: In addition to those disclosures generally permitted under 5 U.S.C.552a(b) of the Privacy Act, records or information
contained in this system may be disclosed outside DOI as a routine use pursuant to 5 U.S.C. 552a(b)(3) to other Federal, state and
local governments, tribal organizations, and members of the general public upon request for names, addresses and phone numbers of
Commercial Use Authorizations (CUA) holders conducting business within units of the National Park System for the purpose of
informing the public of the availability of the services offered by the CUA holder. In addition, records or information contained in this
system may be disclosed outside DOI based on an authorized routine use when the disclosure is compatible with the purpose for which
the records were compiled as described under the system of records notice for this system.
Disclosure: Voluntary, however, failure to provide the requested information may impede our ability to 1) manage the National Park
Service (NPS) Commercial Services Program allowing commercial uses within a unit of the NPS, 2) monitor resources that are or may
be affected by the authorized commercial uses, and 3) provide the public the description and contact information for businesses that
provide services in national parks.
PAPERWORK REDUCTION ACT STATEMENT
We collect this information under the authority of Title IV of the National Parks Omnibus Management Act of 1998 (Pub. L. 105–391).
We use this information to evaluate a concession proposal. Your response is required to obtain or retain a benefit. We may not collect
or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB control number.
OMB has approved this collection of information and assigned Control No. 1024-0029.
ESTIMATED BURDEN STATEMENT
We estimate that it will take you 2 hours to complete this form, including time to review instructions, gather and maintain data, and
complete and review the form. You may send comments on the burden estimate or any aspect of this form to the Information
Collection Clearance Officer, National Park Service at [email protected] (email). Please do not send your completed form to this
address.
Page 11 of 11
| File Type | application/pdf |
| Author | EChavis |
| File Modified | 2023-05-01 |
| File Created | 2019-12-10 |