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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 -2020 <br />Project Name: JACKIE ROBINSON TRAINING COMPLEX TICKET OFFICE BUILDING <br />RENOVATIONS <br />Bidder's Name t Address: DE LA HOZ BUILDERS, INC. <br />258 Del Monte Rd, Sebastian, FL 32958 <br />2. Bidder's Telephone & FAX Numbers: 772-228-9723 <br />Fax : 772-589-8127 <br />Licensing and Corporate Status: <br />a. Is Contractor License current? Yes <br />b. Bidder's Contractor License No: CGC1514151 [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: 15 -rears <br />5. What is the last project OF THIS NATURE that the firm has completed? <br />Repair damage Hurricane Irma Building 992 - Patrick Air Force <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? 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 drug-free workplace program in compliance with Florida <br />Statute 287.087? Yes <br />00456 - Qualifications Questionnaire <br />00456 - t <br />FARWic WorkslENGINEERING DIVISION PRQJECTS12020 JRTC Ticket Office Renovaticns41-RdnWaids0d DocLanem4Rebitl100456 - Quahrications Queslionnaire.doc <br />