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SECTION 00456 — QUALIFICATIONS QUESTIONNAIRE <br /> NOTICE: THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NOW <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 a be considered sufficient justification to disqualify a Bidder. Attach additional sheets as <br /> --- required. <br /> Documentation submitted with Project No: 't <br /> Project Name � <br /> • Sandridge Golf course— Drlvin Ran a Tee Renovations <br /> .ers �a <br /> Bidder's Name /Address: <br /> —+y •• ...•Y _^rte"'. <br /> �..s •ter —«y �_f•• 'r = J r f <br /> 2. Bidders Telephone & FAX Numbers: r <br /> 3. Licensing and corporate Status: } �` �• <br /> a. is contractor License current? - , <br /> b. Bidder's contractor License No: C ck f [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 fists 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 /> f wr <br /> of the type involved in this contract: .- <br /> 5. What is the last project OF THIS MATURE that the firm has completed? <br /> ry <br /> work awarded to you? <br /> 5, Has the firm ever faded to complete y . <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? <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 /> our answer is "yes", then attach a separate page to this questionnaire that explains <br /> [If y number <br /> the circumstances and list the project name, owner, and the owners telephone num <br /> for each project in which OSHA violations were alleged,] <br /> 00456-Qualifications Questionnaire.doc <br /> 00456-1 <br /> FAP ublic WorkslENG1NEER ING DIVlS1GN PROJECTMI21 O-Sandridge Driving Range Tee Renovation)AdmlmWd documentsXO0456-Qualifications questionnaire.dvo <br /> SmeadSoft Reprint Date:Monday,January 11,2016-09:21:50-OfficialDocuments:9069,Attachment Id 1,Page 31 <br />