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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 Submitted with Project No: IRC -1606 <br />Project Name: INDIAN RIVER BOULEVARD AND GRAND HARBOR BOULEVARD <br />SIGNALIZATION <br />1. Bidder's Name /Address: SUNSHINE LAND DESIGN, INC <br />3291 SE LIONEL TERRACE, STUART FLORIDA 34997 <br />2. Bidder's Telephone & FAX Numbers: 772-283-2648 <br />772-283-8944 - FAX <br />3. Licensing and Corporate Status: <br />a. Is Contractor License current? YES <br />b. Bidder's Contractor License No: [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 lists the names and titles of all <br />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: TWENTY FIVE YEARS <br />5. What ITY OF P�R teST LUCIE NATURE <br />the firm PSL BLVD IMPROVEMENTS <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 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? YES PLEASE SEE ATTACHED <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 liquidated damages have been assessed.] <br />8. Has the firm ever been charged by OSHA for violating any OSHA regulations? <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 drug-free workplace program in compliance with Florida <br />Statute 287.087? YES <br />00456 - Qualifications Questionnaire <br />00456 - t <br />F:\PublicWorks\ENGINEERING DIVISION PROJECTS\1606 Indian River Blvd and Grand Harbor Blvd -Mast Arms\1-Admin\Bid Documents\Master Contract Documents Re- <br />Bid1D0456 - Qualifications Questionnaire.doc <br />