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� I <br />� I <br />� I <br />II <br />� I <br />IRC -2204 <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 -2204 <br />Project Name: DICK BIRD PARK PICKLEBALL COURTS <br />Bidder's Name / Address: BARTH CONSTRUCTION, INC. <br />1717 Indian River Blvd Suite 202A - Vero Beach FL 32960 <br />2. Bidder's Telephone & FAX Numbers: Phone: 772-778-3072 <br />Fax: 772-770-3017 <br />3. Licensing and Corporate Status: <br />a. Is Contractor License current? Yes <br />b. Bidder's Contractor License No: CGC1527693 <br />[Attach a copy of Contractor's License to the bid] (Attachment located at end of this document) <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. (Attachment located at end of this document) <br />4. Number of years the firm has performed business as a Contractor in construction work of <br />the type involved in this contract: 43 Years <br />5. What is the last project OF THIS NATURE that the firm has completed? <br />Harbour Ridge Yacht & Country Club - Pickleball Courts (8 courts) <br />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 chargee 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 />9. Has the firm implemented a drug-free workplace program in compliance with Florida <br />Statute 287.087? Yes <br />Qualifications Questionnaire - 00456 - 1 <br />F1Public Works\ENGINEERING DIVISION PROJECTS\2204 Dick Bird Park -Pickle Ball Court\t-Admin\Bids\Bid Documents\DIV 0_1_Bid and Contract Doc_IRC-2204.docx <br />