Laserfiche WebLink
SECTION 00456 - QUALIFICATIONS QUESTIONNAIRE <br /> NOTICE: THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NOW <br /> I RESPONSIBLE BIDDERS . <br /> - z 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. 0399 <br /> Project Name : NORTH COUNTY REGIONAL PARK. PHASE 2 <br /> � i <br /> 1 . Bidder's Name / Address : 13AZT4 Qt Lt Tl ot:Tio►.l , kt- <br /> l "irt WNAIA 21VE2. QSL.%Jr> * 202A4 JE2o Q64CA , Rw 329toD <br /> 2 . Bidder's Telephone & FAX Numbers: ` 123o lcrM 110 -3oi '1 CFA*) <br /> 3. Licensing and Corporate Status : 40S a. Is Contractor License current? <br /> i b. Bidder's Contractor License No: L4 - C j=7t3cf " [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 thetYP a involved in this contract: Zto <br /> 5. What is the last project OF THIS NATURE that the firm has completed? <br /> South- Cmgory Oae /c - Prose. /I <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? N0 <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? leo <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 - t 0399-00456 - Qualifications Questionnaire.doc <br /> FAEnglneeringlCapflei Prolects10399 North County Regional Park, Phase 1110399 Contract Doesk0399.00456 - Qualhlcallons Ques0onnalre.doc Rev. 05/01 <br />