Laserfiche WebLink
SECTION 00456 - QUALIFICATIONS QUESTIONNAIRE <br />NOTICE: THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NON - <br />RESPONSIBLE BIDDERS. <br />UNDER PENALTY OF PERJURY, the undersigned Bidder Guarantees the truth and accuracy <br />of all statements and answers herein contained. Failure to comply with these requirements <br />may be considered sufficient justification to disqualify a Bidder. Attach additional sheets as <br />required. <br />Documentation Submitted with Project No: 1413 <br />Project Name: Martin Luther King Walking Trail <br />1. Bidder's Name / Address: t�OK I+Vtt.� 1 <br />u1 o‘d b uLk� kou Veorae h fL azacvv <br />2. Bidder's Telephone & FAX Numbers:1—1 Z _ ki;1700'T12. 541 -7 6-6-s <br />3. Licensing and Corporate Status: �.t <br />a. Is Contractor License current? 1 eS <br />b. Bidder's Contractor License No: c rC.OSZ94O [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: ?..-Le <br />5. What is the last project OF THIS NAT RE that the firm has completed? <br />OVA. Dv14 AJ9 w acV y <br />6. Has the firm ever failed to complete work awarded to you? (\O <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? x(10 <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 />00456 - Qualifications Questionnaire <br />00456-1 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS \1413 -Martin Luther King Walking Trail \Admin\bid documents\MasterContract Documents\00456-Qualifications <br />Questionnaire.doc <br />