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2017-027F
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Last modified
10/6/2017 11:00:52 AM
Creation date
3/21/2017 2:21:42 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
02/21/2017
Control Number
2017-027F
Agenda Item Number
12.F.1
Entity Name
Community Asphalt Corporation
Subject
Round Island Park Pavement Resurfacing
Contract & Specifications
Area
Round Island Park
Project Number
1619
Bid Number
201717
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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: 1619 <br /> Project Name: ROUND ISLAND RIVERSIDE PARK PAVEMENT RESURFACING <br /> 1. Bidder's Name I Address: Community Asphalt,Corp <br /> 2975 Industrial Blvd.,Vero Beach FL 32967 <br /> 2. Bidder's Telephone & FAX Numbers: ph: (772)770-3771,fax: (772)770-3707 <br /> 3. Licensing and Corporate Status: <br /> a. Is Contractor License current? Yes <br /> b. Bidder's Contractor License No: CGC1521192 [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: 36 <br /> 5. What is the last project OF THIS NATURE that the firm has completed? <br /> Please see attached list of projects completed <br /> 6. Has the firm ever failed to complete work awarded to you? No <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? No <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? No <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 /> 00455-Qualifications Questionnaire <br /> 00456-1 <br /> FAPublic Works%ENGINEERING DMSION PROJECTS11619 Round Island Feality PwAnMt-Adrn"bid documetftWaster Contrad Documents=456-Qualifications <br /> Quostionnaire.doc <br /> i <br />
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