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Bid No. 2018045/IRC-1502 <br />BIDDERS 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 may . <br />be considered sufficient justification to disqualify a Bidder. Attach additional sheets as required. <br />Documentation Submitted with Project No: IRC -1502 <br />Project Name: GIFFORD AREA STORMWATER PROJECT <br />1. Bidder's Name /Address: Johnson -Davis Inc. <br />604 Hillbrath Drive. Lantana; FL 33462 <br />2. Bidder's Telephone ,& FAX Numbers: Phone: 561-588-1170 Fax:561-585-5252 <br />3. Licensing and Corporate Status: <br />a. Is Contractor License current? Yes. <br />b. Bidder's Contractor License No: ' cuc043067 [Attach a copy of <br />Contractor's License to the bid] <br />C. Attach documentation from the State of Florida Division of Corporations <br />that indicates the business entity's status is active and that lists the names and titles <br />of 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: 40 years <br />5. What is the last project OF THIS NATURE that the firm has completed? <br />- Sarno Lakes Phase 2 <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 <br />explains the circumstances and list the project name, Owner, and the Owner's telephone <br />number 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'aftach a separate page to this questionnaire that <br />explains the circumstances and list the project name, Owner, and the Owner's telephone <br />number 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 />Page 17 of 37 <br />i <br />