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do * <br /> SECTION 00456 — QUALIFICATIONS QUESTIONNAIRE <br /> J�W <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 : 0517 <br /> Project Name : Oslo Road Phase III Roadway Improvements ( 58th Avenue to 43rd Avenue ) <br /> 1 . Bidder' s Name / ddress : vvt ILI` <br /> 2 . Bidder' s Telephone & FAX Numbers : V7 ; oo <br /> 3 . Licensing and Corporate Status : <br /> a . Is Contractor License current ? �l <br /> b . Bidder' s Contractor License No : 4 [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 <br />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 : 025 vea VLS <br /> 5 . What is the last project OF THIS NATURE that the firm has completed ? <br /> 6 . Has the firm ever failed to complete work awarded to you ? ) 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 the firm failed to complete the work . ] <br /> 7 . Has the firm ever been assessed liquidated damages ? �U <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 ? 1v � <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 - 1 <br /> F :\Public WorWENGINEERING DIVISION PROJECTS\0517-OSLO ROAD_43rd Ave to 58th Ave-Phase IMAdmim\bid documents\00456 - Qualifications Questionnaire. doc <br />