2012-211A - Laserfiche WebLink

Home Browse Search

SECTION - 00456 - tQUALIFI.CATIONS QUESTIONNAIRE NOTICE : THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NOW RESPONSIBLE BIDDERS . . undersignedUNDER Bidder Guarantees the truth and accuracy oval statements a dF nswe sRhere n 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: 1131 Project Name : , Indian' River Boulevard Resurfacing 141st ;Street to 53"' Street) 1Bid41 . der's Name / Address : �Dty1M0111 A- h- fZ a — Q 9 1S''1t2L X1-.1 +Z 1 a; P1h '3P J f1 hV I - c'i to • 2 . Bidder's Telephone & FAX Numbers : '� � - . 31tn • . 1 dated 3. Licensing and Corporate Status : a . Is Contractor License current? b . Bidders, Contractor License No: 0E„n_ n it �}g [Attach a copy of Contractors 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 . 4. Number of years the firm has performed business as a Contractor in construction work of the type' involved . in this contract: c Ara S 5 . What is the last project . OF THIS NATURE that the firm has . completed? 6e e. N4 Reil, S IJ_ e�7 M, 9AM0942i L & 6. Has the firm ever failed to complete work awarded toyou? [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 Owners telephone number for each project in which the firm failed to complete the work.] 7 . Has the firm ever been assessed liquidated damages? � [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 Owners 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? [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 OSHA violations were alleged . ] 00456 - Qualifications Questionnaire.doc 00456 - t FAIDublic Woft\ENGINEERING DIVISION PROJECTS I1314R Blvd Resurfacing 41st St to 53rd 3t-SEE PROJ 0927%drri tContract Docunrents\00456 - Qualifications AuaeHnnnaira.doc .