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SECTION 00456 -- QUALIFICATIONS QUESTIONNAIRE <br />NOTICE: THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NON - <br />RESPONSIBLE BIDDERS. <br />Documentation SubmittedwithProject No: IRC -1628 <br />Project Name: VERO LAKE ESTATES 85th STREET MILLINGS FROM 1011: AVENUE <br />TO 96th AVENUE <br />1. Bidder's Name / Address: Timothy Rose. Contracting <br />136o SW Old Dixie Hwy Suite 106 Vero Beach FL 32962 <br />2. Bidder's Telephone & FAX Numbers: 772.564.7800 / 772.564.7888 <br />3: Licensing and Corporate Status; <br />a. Is Contractor License current? Yes <br />b. Bidder's Contractor License No CGC052940 [Attach a copy 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: 28 <br />5. What is the .last project OF THIS NATURE that the firm has completed? <br />City of Sebastian Street Milling & Paving: <br />6. Has the firrn ever failed to complete work awarded to you? 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 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 attach a separate page to this questionnaire thatexplains <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? 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 />9. Has the firm implemented a drugfree workplace program in compliance with Florida <br />Statute 287.087? Yes <br />00456 - Qualifications :QueStW0riaire <br />00456 -. 1 <br />F;tpublic Works\ENG1NEERINt DIVISION"PROJECTS\1628 851h SVee_l 96th Ave to 101st Ave_ Roadway Improvemenlsl9-Admin\Blds\Bid Docunwnls\Meelei C9nlrael <br />Documenls100456 -Qualifications Quesllonnairo.doc <br />