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2022-132A
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2022-132A
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Last modified
9/13/2022 12:03:35 PM
Creation date
9/13/2022 11:36:01 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
07/12/2022
Control Number
2022-132A
Agenda Item Number
12.G.1.
Entity Name
C.W. Roberts Contracting, Inc
Subject
Indian River Blvd Resurfacing from 53rd Street to the Merrill Barber Bridge
FDOT FM 441919-1-54-01
Project Number
IRC-1707
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IRC -1707 <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 -1707 <br />Project Name: INDIAN RIVER BOULEVARD RESURFACING FROM 53RD STREET TO THE <br />MERRILL BARBER BRIDGE <br />1 . Bidder's Name / Address: C. W. Roberts Contracting, Inc <br />8530 SW Jayme Way, Palm City, FL 34990 <br />2. Bidder's Telephone & FAX Numbers: Telephone -772-288-0951 Fax -772-288-0983 <br />3. Licensing and Corporate Status: <br />a. Is Contractor License current? Yes <br />b. Bidder's Contractor License No: CGC 1505785 <br />[Attach a copy of 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 <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: d6 <br />What is the last project OF THIS NATURE that the firm has completed? <br />T4544 US Highway 1 Resurfacing <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 />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 />FAPublic Works\ENGINEERING DIVISION PROJECTSN1707 Indian River Blvd Merrill Barber Bridge to 53rd Sl Resurfacing (SCOP)11.AdminiBld Documents\Bid <br />DocumenlslDIV 0_1_Bid and Contract Ooc_IRC-1707.docx <br />
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