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Bid No. 2020048/IRC-1816 <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 of all <br />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 -1816 <br />Project Name: INDIAN RIVER COUNTY WELCOME SIGNS <br />1. Bidder's Name /Address: <br />2. Bidder's Telephone & FAX Numbers:--" % �` l3�plv;—,,29114 <br />C�i/ 9-6'Y <br />3. Licensing and Corporate Status: <br />a. Is Contractor License current? e <br />b. Bidder's Contractor License o:i2;1,C/;? [Attach a copy of <br />Contractor's 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 of the <br />type involved in this contract: 1 `' <br />5. What is the last project OF THIS NATURE that the firm has completed? <br />6. Has the firm ever failed to complete work awarded to you? 11 C <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 for <br />each project in which the firm failed to complete the work.] <br />7. Has the firm ever been assessed liquidated damages? I i L' <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 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? i Ji ' <br />Page 20 of 39 <br />