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N 00456 - QUALIFICATIONS QUESTION <br />NOTICE: THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NON - <br />RESPONSIBLE BIDDERS. <br />UNDER PENALTY OF PERJURY, the undersigned Bidder Guarantees the truth and accuracy <br />of all statements and answers herein contained. Failure to comply with these requirements <br />may be considered sufficient justification to disqualify a Bidder. Attach additional sheets as <br />required. <br />Documentation Submitted with Project No: 0206 <br />Project Name: a Street SW / 43`d Avenue Bridge Replacement and Intersection <br />Improvements <br />Bidder's Name / <br />1 <br />Telephone & FAX Numbers. <br />2. Licensing and Corporate Status: <br />a. Is Contractor License current? �S <br />b. Bidder's Contractor License No: [Attach a copy of Contractor's <br />License to the bid] <br />c. Attach documentation from the State of Florida Division of Corporations that <br />indicates the business entity's status is active and that lists the names and titles of <br />all officers. <br />3. Number of years the firm has performed business as a Contractor in construction work <br />of the type involved in this contract:3 ) <br />4. Wohat is tAAe mast p�ojec SOF THIS NA URE that the firm has completed? <br />5. Has the firm ever failed to complete work awarded to you? 0 <br />[If your answer is "yes, then attach a separate page to this questionnaire that explains <br />the circumstances and list the project name, Owner, and the Owner's telephone number <br />for each project in which the firm failed. to complete the work.] <br />7.. Has the firm ever been assessed liquidated damages?O <br />[If your answer is "yes, then attach a separate page to this questionnaire that explains <br />the circumstances and. list the project name, Owner, and the Owner's telephone number <br />for each project in which liquidated damages have been assessed.] <br />8. Has the firm ever been charged by OSHA for violating any OSHA regulations . <br />