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2018-062A
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2018-062A
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Last modified
12/29/2020 10:08:58 AM
Creation date
4/25/2018 4:40:43 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
04/03/2018
Control Number
2018-062A
Agenda Item Number
8.E.
Entity Name
Indian River County Jail Complex
Subject
Roofing replacement, recover, and repair project
Project Number
IRC-1735
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SECTION. 004466 - QUALI ATI,ONS :gUESTIONNAtRE <br />NOTICE: THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NOW <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 Subrniitted with Project No: IRC -1735 <br />Project Name: IRC JAIL COAAPLEX:RO{iFIMG REPLAGEIMEIs#T..RECQVER AND REPAIi2 <br />PRO <br />JECT, <br />1: Bidder's Name [Address /G 0 :./4 <br />6JZ2A) 4-75 v--"7 <br />2. Bidder's Telephone & FAX Numbers: Phorm. % — 93 <br />3. Licensing and Corporate Status: <br />a. Is Contractor License current? Y66 _ <br />b. Bidder's Contractor License No: C'.CL l3,2 [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 fists the names and titles of <br />all officers. <br />4. Number of years the firm has performed biaMness as.a Contractor.in construction work <br />of the type involved in this contract: <br />5. Wbat is the last project OF THIS NAJjRE that the.firm has completed? <br />8: Has the firm ever failed to complete work awarded .to you? fJp <br />[If your answer is "yes°, then attach a separate page to this: questionnaire that w0ains <br />the circumstances and list the project name, Owper,.and the Ownees 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 pago.to this questionnaire; that ewains <br />the circumstances and list the prged- 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 vlowng any,OSHA regulations? <br />004M - GtuWfx&WM QuesdannWre <br />00466-r <br />FTubhoWaWEfttiTFVMIIIGDMIONPROMCM1735 MC M C=p=RodR of ap rhgJpdU-AbruinW <br />ITacip456 - a Quaatio�msae.dx <br />
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