Laserfiche WebLink
`l SECTION 00456 —QUALIFICATIONS QUESTIONNAIRE <br />t� <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: 0205 <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?_ <br />00456 - Qualificabons Quesbonnaire.doc <br />00456 - t <br />F:\Er4neeringkCapftal Prolects10205 old awe Highway Bridge over the south Relief CanaIW205 Contract Document: & Spacs\00458. Qualifications Quesbonnaire.doc <br />Project Name: Bridge replacement at Old Dixie Hwy. over the South Relief Canal with <br />Roadway and Drainage Improvements. <br />1. <br />Bidder's Name / Address: 1)1 CKOZ5d r� rt- C) g 10 <br />To Ci: + P 6 in <br />2. <br />Bidder's Telephone & FAX Numbers: T7 <br />3. <br />Licensing and Corporate Status: ` <br />a. Is Contractor License current? 7 5 <br />b. Bidder's Contractor License No: .06)o -7 4'7 [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. <br />Number of years the firm has performed busine s as a Contractor in construction work <br />of the type involved in this contract: <br />'s�TAtht <br />5. <br />W t <br />�� I t project OF THIS NATURE th t the firm has completed? <br />51�. l..rLG l G Gp��ctV'f <br />6. <br />Has the firm ever failed to complete work awarded to you? 140 <br />"yes, <br />[If your answer is 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. <br />Has the firm ever been assessed liquidated damages? 14 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 liquidated damages have been assessed.] <br />8. Has the firm ever been charged by OSHA for violating any OSHA regulations?_ <br />00456 - Qualificabons Quesbonnaire.doc <br />00456 - t <br />F:\Er4neeringkCapftal Prolects10205 old awe Highway Bridge over the south Relief CanaIW205 Contract Document: & Spacs\00458. Qualifications Quesbonnaire.doc <br />