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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 : 1341 <br /> Project Name : Historic Dodgertown Room Renovations <br /> 1 . Bidder' s Name / Address : (9A C ker, t dh <br /> 2 . Bidder' s Telephone & FAX Numbers : Cie ` � � 55 � ZL <br /> 3 . Licensing and Corporate Status : <br /> a . Is Contractor License current? V2 S <br /> _ b . Bidder's Contractor License No : drec. 04 / Sy t [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: / 6 elks <br /> 5 . What is the <br /> lla t oject OF (THIS NATU E-r hat the firm has completed? <br /> % <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? Ny <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? POP <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;1Public Works1ENGINEERING DIVISION PROJECTS\1341 -Historic Dodgertown (fka VB Sports Village) Room Renovadons)V+dminlbid documents\Master Contract <br /> '— DocsXMaster Contract Documents100456 - Qualifications Questionnaire. doc <br />