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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: IRC -1415 <br />Project Name: INDIAN RIVER BOULEVARD SIDEWALK FROM 372' STREET TO 53rd <br />STREET <br />1 <br />2. <br />Bidder's Telephone & FAX Numbers:117 .Sing .'TTO Q n:)? <br />3. Licensing and Corporate Status: <br />a. Is Contractor License current? Ics <br />b. Bidder's Contractor License No: C4 � [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?1 <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 />00456 - Qualifications Questionnaire <br />00456 - 1 <br />F9Publlc Woft%ENGINEERING DIVISION PROJECTS%1415-IR Blvd Sldewall 37th Sl to 53rd SM-Adminlbid documenlsWaster Contract Doamrents100456 - Qualifications .: . <br />Questlonnalre.doc <br />