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i SECTION 00456 - QUALIFICATIONS QUESTIONNAIRE NOTICE: THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NON - RESPONSIBLE BIDDERS. UNDER PENALTY OF PERJURY, the undersigned Bidder Guarantees the truth and accuracy of all statements and answers herein contained. Failure to comply with these requirements may be considered sufficient justification to disqualify a Bidder. Attach additional sheets as required. ' Documentation Submitted with Project No: 1132 Project Name: CR 512 Resurfacing (East Bound Only) (Roseland Road to Easy Street) 1. Bidder's Name /Address: Ranger Construction Industries, Inc. 1200 Elboc Way Winter Garden, FI. 34787 2. Bidder's Telephone & FAX Numbers: PH: 407-656-9255 FX: 407-656-3188 J 3. Licensing and Corporate Status: a. Is Contractor License current? Yes j b. Bidder's Contractor License No: CGCO19416 [Attach a copy of Contractor's License to the bid] c. Attach documentation from the State of Florida Division of Corporations that indicates the business entity's status is active and that lists the names and titles of all officers. 4. Number of years the firm has performed business as a Contractor in construction work ' of the type involved in this contract: 31 5. What is the last project OF THIS NATURE that the firm has completed? - City,of Debary Resurfacing Vousia county. Resurfacing 6. Has the firm ever failed to complete work awarded to you? no [If your answer is `ryes, then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which the firm failed to complete the work.] j 7. Has the firm ever been assessed liquidated damages? no [If your answer is "yes, then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which liquidated damages have been assessed.] 8. Has the firm ever been charged by OSHA for violating any OSHA regulations? Yes see attached [If your answer is "yes, then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which OSHA violations were alleged.] 00456 - t 00456 - Qualifications Questionnaire,doc . FAPublic Works\ENGINEERING DIVISION PROJECTS11132-CR 512 Ebnd Resurfacing Roseland Rd to Easy St -SEE PROJ 0926MMmTontracl Documenls100456 - Qualifications Questionnaire,doc