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IRC -1639 (In the case of a tie, preference will be given to businesses with drug-free workplace programs) 10. Has the firm ever been charged with noncompliance of any public policy or rules? No [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project.] 11. Attach to this questionnaire, a notarized financial statement and other information that documents the firm's financial strength and history. 12. Has the firm ever defaulted on any of its projects? No [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which a default occurred.] 13. Attach a separate page to this questionnaire that summarizes the firm's current workload and that demonstrates its ability to meet the project schedule. 14. Name of person who inspected the site of the proposed work for the firm: Name: Timothy Rose Date of Inspections: 15. Name of on-site Project Foreman: Christopher Dial 3116/22 Number of years of experience with similar projects as a Project Foreman: 16 16. Name of Project Manager: Timothy Rose Number of years of experience with similar projects as a Project Manager: 37 17. State your total bonding capacity: 40,000,000.00 18. State your bonding capacity per job: 15,000,000.00 19. Please provide name, address, telephone number, and contact person of your bonding company: Westfield Ins. Co., 1 Park Cir., Westfield Center, OH 44251, Dan Sheehan 904-661-4708 [The remainder of this page was left blank intentionally] Qualifications Questionnaire - 00456 - 2 FAPubIIc WorksIENGINEERING DIVISION PROJECTS\1639 89th Street 66th Avenue to US -1 Resurfacing (SCOP)11-AdMniBidslBid Documents - Adver isement0V 0_1—Bidding Documents - 20210824.docx