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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: 1210 <br /> Project Name: Sandridge Golf Course— Driving Range Tee Renovations <br /> 1. Bidder's Name /Address: <br /> +1 <br /> 2. Bidder's Telephone & FAX Numbers: :jf rA f <br /> 3. Licensing and Corporate Status: <br /> a. Is Contractor License current? '= m <br /> b. Bidder's Contractor License No: C OLA=Z 59;,) t [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 /> 00b f e `' rr-o <br /> - f , <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 /> A��- <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.doc <br /> 00456-1 <br /> F1Public Works1ENGINEERING DIVISION PROJECTSM10-Sandridge Driving Range Tee RenovationlAdmimlbid documents100456-Qualifications Questionnaire.doc <br />