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[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 />9. Has the firm implemented a drug-free. workplace program in compliance with Florida <br />Statute 287.087? <br />(In the case of a tie, preference will be given to businesses with drug-free workplace <br />programs). <br />10. Has the firm ever been charged with noncompliance of any public policy or rules? <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.] <br />11. Attach to this questionnaire, a notarized financial statement and other information that <br />documents the firm's financial strength and history. ' <br />12. Has the firm ever defaulted on any of -its projects? J0 <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 a default occurred.] <br />13. Attach a separate page to this questionnaire that summarizes the firm's current <br />workload and that demonstrates its ability to meet the project schedule. <br />14. Name <br />�-oof-person who inspected the site of the proposed work for the firm:. <br />Name: IAW��,� `k'�o Date of Inspections: <br />J <br />15. Name of on-site Project Foreman: Vllyyt�i y <br />Number of years of experience with similar projects as a Project Foreman:-_ i <br />I <br />16. Name of Project Manager: du -A" <br />Number of years of experience with similar projects as a Project Manager:_ <br />17. State your total bonding capacity: C) AAAALAQ C) <br />18. State your bonding capacity per job:— <br />19. Please provide name, add��r'�e""ss,,� telephone number, and contact person of your <br />bonding company: \; ;�j1';1___ �1�, 115• L'U <br />[The remainder of this page was left blank intentionslly]]� , e25 ! F0 <br />00456 Qu lifica �y Questionnaire <br />ir+., l <br />00456-2 <br />F:Wublic WorksIENGINEERING DIVISION PROJECTV415-IR Blvd Sidewalk 37th Stto53rd Sl\1-Adminlbld documents\MasterConlract DocumentMOD456 -Qualifications <br />Questionnalre.doc - - - <br />