|
Person Responsible |
Date Received |
Item Description |
|
___________ |
___________ |
Financial statements for last 3 years, plus interim (including Auditors report, if available) |
|
___________ |
___________ |
Monthly summary income statement schedule for last 12 months |
|
___________ |
___________ |
Federal Income Tax returns for last 3 years |
|
___________ |
___________ |
State Income Tax returns for last 3 years |
|
___________ |
___________ |
Detail schedule of G&A costs for the current year (min. of 6 months) |
|
___________ |
___________ |
Copies of all debt agreements booked against these assets |
|
___________ |
___________ |
Copy of current and prior year budgets |
|
___________ |
___________ |
Accounts receivable aging as of the most recent month end for assets |
|
___________ |
___________ |
Schedule of write-offs for the current and prior year |
|
___________ |
___________ |
Accounts payable aging as of the most recent month end |
|
___________ |
___________ |
Current detailed Inventory schedule, with volumes and values (applies to on-site devices, etc.) |
|
___________ |
___________ |
Copies of lease agreements (other than real estate) |
|
___________ |
___________ |
Discussion of contingent liabilities (bonus's, earnout agmts., EEOC, SEC, IRS, etc.) |
|
___________ |
___________ |
Discussion of any purchasing, financing, royalty, franchise or other commitments |
|
___________ |
___________ |
Personnel organization chart ( this will give them an idea of how clients interact with you) |
|
___________ |
___________ |
Listing of employees, showing location, job description, pay rate, and date of hire |
|
___________ |
___________ |
Schedule of benefits plans, with supporting documentation |
|
___________ |
___________ |
Discussion of all lawsuits for past three years |
|
___________ |
___________ |
Discussion of any threatened or pending legal action |
|
___________ |
___________ |
Corporate legal structure |
|
___________ |
___________ |
Discussion of operations, accounting, and sales management software |
|
___________ |
___________ |
Laboratory contract and sample billing for most recent month |
|
___________ |
___________ |
Medical Review Officer contracts and sample billing for most recent month |
|
___________ |
___________ |
Copies of all distribution contracts, if any |
|
___________ |
___________ |
Copies of all employment agreements |
|
___________ |
___________ |
Copies of subcontractor agreements |
|
___________ |
___________ |
Copies of contract labor agreements, and schedule of contract personnel |
|
___________ |
___________ |
For both current YTD and prior year, schedule of revenue by contract (agrees to income stmts.) |
|
___________ |
___________ |
Copies of all material contracts (minimum of 75% of total revenue derived above) |
|
___________ |
___________ |
Copies of sales and marketing literature |
|
___________ |
___________ |
Listing of all customers billed in the last 6 months, sorted by revenue |
|
___________ |
___________ |
Copies of recent press releases and/or news articles |
|
___________ |
___________ |
Current sales backlog report, showing customer information with est. volumes and values |
|
___________ |
___________ |
Discussion of selling expenses, ie, commission plans, vehicle leases, marketing costs, etc. |