Laserfiche WebLink
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 : 0845 <br /> Project Name : Old Dixie HiahwaV Sidewalk Improvements from 38 `h Lane to 651h Street. <br /> 1 . Bidder's Name / Address : PAloc . <br /> �O3a C� � � o RoeA Low FC . 3226 <br /> 2 . Bidder's Telephone & FAX Numbers : t4 ! 32,1-(,31 -S52, 3 <br /> �9X 32I - � 3�i oY�i7 <br /> 3. Licensing and Corporate Status : <br /> a . Is Contractor License current? qe S <br /> b . Bidder's Contractor License No : Q834y67 [Attach a copy of Contractor's <br /> License to the bid] - 5ee 4Tr4c4gj�, <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: 23 rs <br /> 5 . What is the last project OF THIS NATURE that the firm has completed ? <br /> aEAu t+ Bw - C Q1 0JV Ca e.4 -rlh'C->21 N2 k . 6AJAM LJ 44 )%tA0490 kMA(11Z <br /> s� rFrs - L' ATL. o � C0c <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 ? N 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 ? ►`' 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 OSHA violations were alleged .] <br /> 00456 - Qualifications Questionnalre .doc <br /> 00456 - 1 <br /> F:Nuhlic Works\ENGINEERING DIVISION PROJECTSM45-Dixie Hay Sidemlk USI 69th (LAP)\Admim\bid documents\00456 - Qualifications Questionnaim.doc <br />