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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 <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: <br /> Project Name: <br /> 1. Bidder's Name/Address: <br /> 2. Bidder's Telephone & FAX Numbers: <br /> 3. Licensing and Corporate Status: <br /> a. Is Contractor License current? <br /> b. Bidder's Contractor License No: [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. Number of years the firm has performed business as a Contractor in construction work <br /> of the type involved in this contract: <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? <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 /> [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(2) <br /> 00456-1 168 <br />