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SECTION 00456 - QUALIFICATIONS QUESTIONNAIRE NOTICE : THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NON- RESPONSIBLE BIDDERS . UNDER PENALTY OF PERJURY, the undersigned Bidder Guarantees the truth and accuracy of all statements and answers herein contained . Failure to comply with these requirements may be considered sufficient justification to disqualify a Bidder. Attach additional sheets as required . Documentation Submitted with Project No : 0206 Project Name : a Street SW / 43`d Avenue Bridge Replacement and Intersection Improvements Bidder's Name / Address : 3 1 . Bidder's Telephone & FAX Numbers. 2 . Licensing and Corporate Status : a . Is Contractor License current? �S b . Bidder's Contractor License No . [Attach a copy of Contractor's License to the bid] c. Attach documentation from the State of Florida Division of Corporations that indicates the business entity's status is active and that lists the names and titles of all officers . 3 . Number of years the firm has performed business as a Contractor in construction work of the type involved in this contract: 3 ) 4 . What is t e last p oject OF THIS NATURE that the firm has completed? � 1Q M S 5 . Has the firm ever failed to complete work awarded to you? 0 [If your answer is "yes , then attach a separate page to this questionnaire that explains the circumstances and list the project name , Owner, and the Owner's telephone number for each project in which the firm failed . to complete the work.] 7. . Has the firm ever been assessed liquidated damages? O [If your answer is "yes , then attach a separate page to this questionnaire that explains the circumstances and. list the project name , Owner, and the Owner's telephone number for each project in which liquidated damages have been assessed .] 8 . Has the firm ever been charged by OSHA for violating any OSHA regulations?