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[If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which OSHA violations were alleged.] 9. Has the firm ever been charged with noncompliance of any public policy or rules? [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project.] 10. Attach to this questionnaire, a notarized financial statement and other information that documents the firm's financial strength and historyrd 11. Has the firm ever defaulted on any of its projects? NO [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which a default occurred.] 12. Attach a separate page to this questionnaire that summarizes the firm's current workload and that demonstrates its ability to meet the project schedule.,/ 13. Name of person who inspected the site of the proposed work for the firm: Name: � �M j��W Date of Inspections: 1. Z.J . ill 14. Name of on-site Project Foreman: Number of years of experience with similar projects as a Project Foreman: booap, 15. Name of Project Manager: �Aa)ZA Number of years of experience with similar projects as a Project Manager: 16. State your total bonding capacity: 10 10A&LAQA 17. State your bonding capacity per job: � -MA 11Lo 1 18. Please provide name, address, telephone number, and contact person of your bonding company:%QST �ACcj_ Pt 0o i' [The remainder of this page was left blank intentionally] QN '-,2,151 00456 - Qualifications Questionnaire 00456-2 F:\Public Works\ENGINEERING DIVISION PROJECTS\1324 58th Ave Resurfacing (N. of 26th St to N. of 571h St)\1-Admin\Bid documents\Master Contract Documents\00456 - Qualifications Questionnaire.doc