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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 : 0550 <br /> Project Name : 58TH Avenue Roadway Modifications <br /> 1 . Bidder's Name / Address : 5 . P S . Cordra- c i rl.( Inc <br /> A 015 Arne r 1. eeckn ck, o cc f S (A, +1 ( 1 , ye-,v e �. c h rL, .3 19 G (o <br /> 2 . Bidder's Telephone & FAX Numbers : <br /> SAX : �77a - -7 -79 - Zgte �, <br /> 3 . Licensing and Corporate Status : <br /> a . Is Contractor License current? y e, S <br /> b . Bidder's Contractor License No : C6G D075 q i [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: 13 \1 4! a rs <br /> 5 . What is the last project OF THIS NATURE that the firm has completed ? <br /> Li4-�I off ' Fz tISrr) Qre �aLIAtI Orcci0- agt <br /> 6 . Has the firm ever failed to complete work awarded to you? L? <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? 1\10 <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? 0 <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 - t <br /> FAPublic Works\ENGINEERING DIVISION PROJECTS\0550 SR60&58th Ave Inlersecllon Improvements (KNA)\Ndmim\BId Documents\00456 - Qualifications <br /> Questlonnalre.doc <br />