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I <br /> SECTION 00456 - QUALIFICATIONS QUESTIONNAIRE <br /> �I <br /> I NOTICE : THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NON - <br /> RESPONSIBLE BIDDERS . <br /> I 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: 0208 <br /> I <br /> i <br /> Project Name : Bridge Replacement and Roadway Improvements on 82"d Ave . at 0 St . <br /> t 1 . Bidder's Name / Address: Lucas Marine Acquisition Company , LLC <br /> I 3130 SE Slater St. , Stuart , FL 34997 <br /> i2 . Bidder's Telephone & FAX Numbers : 772-286-5094 Fax 772403-2378 <br /> 3 . Licensing and Corporate Status : <br /> a . Is Contractor License current? Yes <br /> b . Bidder's Contractor License No : CGC1519919 [Attach a copy of Contractor's <br /> License to the bid] <br /> Go 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 thLtkckS involved ntshin2sutont�ctii 24 aV alo 'Ak�n � nu�, n� F corlsr�w� � ,J, UI C ris 3104;2411) <br /> 5 . What is the last project OF THIS NATURE that the firm has completed ? <br /> Juanita Avenue Bridge , Fort Pierce , FL <br /> FDOT Design/Build <br /> 6 . Has the firm ever failed to complete work awarded to you ? No <br /> i <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 /> SS 7 . Has the firm ever been assessed liquidated damages? Yes <br /> I [ if your answer is `des, 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 /> i for each project in which liquidated damages have been assessed . ] <br /> i <br /> 8 . Has the firm ever been charged by OSHA for violating any OSHA regulations? Yes <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 /> i <br /> 00456 - Qualifications Quesdonnaire.doc <br /> 00456 - 1 <br />