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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 <br />of all statements and answers herein contained. Failure to comply with these requirements <br />may be considered sufficient justification to disqualify a Bidder. Attach additional sheets as <br />required. <br />Documentation Submitted with Project No: IRC -1765 <br />Project Name: SEBASTIAN CORNERS ROOF REPLACEMENT. <br />1. Bidder's Name / Address: The Roof Authority, Inc. <br />6771 North me Hwy. Fort Fierce, H. �AU411J <br />2. Bidder's Telephone & FAX Numbers: <br />772-468-2247 Fax <br />3. Licensing and Corporate Status: <br />772-468-7870 <br />a. Is Contractor License current? Yes <br />b. Bidder's Contractor License No: 05 [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 <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: 25 <br />5. What is the last project OF THIS NATURE that the firm has completed? <br />Piper Aircraft Building 9 <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? 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 liquidated damages have been assessed.] <br />8. Has the firm ever been charged by OSHA for violating any OSHA regulations? Yes <br />00456 - Qualifications Questionnaire <br />00456 - i <br />FAPublic Works\ENGINEERING DNISION PROJECTS\1765 Sebastian Comers Roof Replacement\I-Admin\Bid DocumentsWaster Contract Documents\Master <br />Contract Documents\00456 - Qualifications Questionnaire.doc <br />