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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 of <br />all statements and answers herein contained. Failure to comply with these requirements may be <br />considered sufficient justification to disqualify a Bidder. Attach additional sheets as required. <br />Documentation Submitted with Project No: 0430 <br />Project Name: Egret Marsh Stormwater Park. <br />1. Bidder's Name/ Address: <br />2. Bidder's Telephone, FAX Numbers & Email: <br />L�aC,. ID <br />n <br />3. Licensing and Corporate Status (NOTE: The bidder must be a licensed General <br />Contractor): <br />a. Is General Contractor License current? des <br />b. Bidder's General Contractor License No: [Attach a copy of <br />Contractor's License to the bid] <br />c. Attach documentation from the State of Florida Division of Corporations that indicates <br />the business entity's status is active and that lists the names and titles of all officers. <br />d. Does Contractor have current file with Indian River County Building <br />Department? `les n <br />4. Number of years the firm has performed business as a Contractor in construction workof <br />the type involved in this contract: -1,j 9s.% 0 <br />5. What is the last project COMPARABLE TO THIS PROJECT that the firm has completed? <br />SQe- CkA-�-c;checA a <br />6. Has the firm ever failed to complete work awarded to you? N o a <br />[If your answer is "yes, then attach a separate page to this questionnaire that explains the <br />circumstances and list the project name, Owner, and the Owner's telephone number for <br />each project in which the firm failed to complete the work.] <br />7. Has the firm ever been assessed liquidated damages? 1"-' LJ <br />[If your answer is "yes, then attach a separate page to this questionnaire that explains the a <br />circumstances and list the project name, Owner, and the Owner's telephone number for <br />each project in which liquidated damages have been assessed.] <br />a <br />Last Revised 08/2008 00456-1 Egret Marsh <br />FAPublic Works\Cliff Suthard\1 A A Egret Marsh Redesign Contract Documents Technical Specifications\Div 0\00456 - Qualifications <br />Questionnaire Egret Marsh.doc <br />