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e. <br /> SECTION 00456 — QUALIFICATIONS QUESTIONNAIRE e <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 : 1126 <br /> Project Name : South County Regional Park Multi-Puraose Fields, <br /> 1 . Bidder's Name / Address : Barth Construction , Inc . <br /> 1717 Indian River Blvd , Suite 202A , Vero Beach , FL 32960 <br /> 2 . Bidder's Telephone & FAX Numbers: Phone ( 7 72 ) 778 - 3072 <br /> Fax ( 772 ) 770 - 3017 <br /> 3 . Licensing and Corporate Status : <br /> a . Is Contractor License current? Yes <br /> b . Bidder's Contractor License No: CGCO 0 7 8 4 7 [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: 33 years <br /> 5. What is the last project OF THIS NATURE that the firm has completed? <br /> Fellsmere Senior League Park <br /> 6. Has the firm ever failed to complete work awarded to you? No <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? No <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? No <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.doc <br /> 00456 - i <br /> F:1Publie Workg ENGINEERING DMION PROJECTS11128 - RFP South Co Park Multi Purpose F1eIdd%dm1m1b1d doeumentslCaftct Documents\00458 - Qualifications <br /> nlb6fRR,ICfG , flR <br />