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SECTION 00456 - QUALIFICATIONS QUESTIONNAIRE <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 : 0816 <br /> Project Name : The Enclave Subdivision <br /> 1 . Bidder's Name / Address : iv G <br /> e c vN S <br /> 2 , Bidder's Telephone & FAX . Numbers : ?707 " SQ '? - 3 / d' D <br /> 9 #2a - sg � � y%2 13 <br /> 3 . Licensing and Corporate Status . <br /> a . Is Contractor License current? Yez <br /> b . Bidder's Contractor License No : C6C /5'4 93 93 [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 /> 4 . Number of years the firm has performed business as a Contractor in construction work <br /> of the type involved in this contract: .3 d <br /> 5 . What is the IgIst pr ct OF THIS NATURE that the firm has completed ? <br /> 6 . Has the firm ever failed to complete work awarded to you? � <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? W <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 /> [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 OSHA violations were alleged . ] <br /> 00456 - Qualifications Questionnaire - REV 04-07.doc <br /> 00456 - I <br /> FAEnglneedng%Spedal ProjecWlEndave Subdiviaion\Contract Documenh\Cantract DocumenteWhe Endave.docW0456 - QuallOcations Questionnaire - REV 04-07.doc <br />