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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 />UNDER PENALTY OF PERJURY, the undersigned Bidder Guarantees the truth and accuracy of <br />all statements and answers herein contained. Failure to comply with these requirements may be <br />considered sufficient justification to disqualify a Bidder. Attach additional sheets as required. <br />Documentation Submitted with Project No: IRC -1414 <br />Project Name: 4911" STREET MILLING AND RESURFACING (581L1 AVENUE TO 31ST AVENUE <br />1. Bidder's Name / Address: Geuttler Brothers Construciton, LLC <br />4401 Whiteway Dairy Rd. Ft. Pierce, FL 34947 <br />2. Bidder's Telephone & FAX Numbers: PH: 772-461-8345 <br />3. Licensing and Corporate Status: <br />a. Is Contractor License current? Yes <br />b. Bidder's Contractor License No: CGC1511503 [Attach a copy of Contractor's <br />License to the bid] <br />c. Attach documentation from the State of Florida Division of Corporations that indicates <br />the business entity's status is active and that lists the names and titles of all officers. <br />4. Number of years the firm has performed business as a Contractor in construction work of <br />the type involved in this contract: 13 <br />5. What is the last project OF THIS NATURE that the firm has completed? <br />Please see attached list of projects completed <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 the <br />circumstances and list the project name, Owner, and the Owner's telephone number for <br />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 that explains the <br />circumstances and list the project name, Owner, and the Owner's telephone number for <br />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 the <br />circumstances and list the project name, Owner, and the Owner's telephone number for <br />each project in which OSHA violations were alleged.] <br />00456 - Qualifications Questionnaire <br />00456 - 1 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1414-49th St_58th Ave to 31st Ave\1-Admin\Bids\Bid Documents\Master Contract Documents\00456 - Qualifications <br />Questionnaire.doc <br />