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IRC -1639 <br />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 -1639 <br />Project Name: 69TH STREET FROM 66TH AVENUE TO SR51US-1, RESURFACING_ <br />Bidder's Name / Address: Timothy Rose Contracting, Inc. <br />Bidder's Telephone & FAX Numbers: 772-564-7800, Fax 772-564-7888 <br />3. Licensing and Corporate Status: <br />a. is Contractor License current? Yes <br />b. Bidder's Contractor License No: 052940 <br />[Attach a copy of Contractor's License to the bid] <br />G. 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 <br />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: 31 years <br />5. What is the last project OF THIS NATURE that the firm has completed? <br />58th Ave Resurfacing/Reclamation from 57th St. to 85th St <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 <br />number 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 <br />number 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 <br />number for each project in which OSHA violations were alleged.] <br />Has the firm implemented a drug-free workplace program in compliance with Florida <br />Statute 287.087? Yes <br />Qualifications Questionnaire - 00456 -1 <br />F:\Pub1JcWorks\ENGINEERING DIVISION PROJECTS11639 69th Street 66th Avenue to US -1 Resurfacing (SCOP)\1-Adm9n\8ids1Bid Documents-Advertlsement\OIV <br />0_1—Bidding Documents - 20210824.docx <br />