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SECTION 00456 - QUALIFICATIONS QUESTIONNAIRE <br /> NOTICE : THE OWNER RETAINS THE DISCRETION TO REJECT THE BIDS OF NOW <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 /> 1 Documentation Submitted with Project Nov, 9219A <br /> Project Name : HARMONY OAKS MITIGATION PROJECT <br /> 1 . Bidder' s Name / Address : Oklawaha Farms , Inc . , 9200 S Dadeland Blvd <br /> # 705 ,. " Miami , FL 33156 <br /> 2 . Bidder' s Telephone & FAX Numbers : Telephone 305 - 670 - 9660 ; <br /> FAX 305 - 670 - 9659 <br /> 3 . Licensing and Corporate Status ( NOTE : The bidder must be a licensed contractor) : <br /> a . Is Contractor License current? yes <br /> b . Bidder's Contractor License No : CG C 0 3 8 2 3 5 [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: 17 <br /> 5 . What is the last project OF THIS NATURE that the firm has completed ? <br /> Wolf Branch Creek Habitat Restoration . The largest habitat <br /> restoration project within the Tampa Bay Watershed . <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 /> t 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 /> 1 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 /> N 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 /> REVISED - 00456 - Qualifications Questionnaire — revised November 24, 2003 <br /> 00456 - 1 HARMONY OAKS <br /> FO.Wublic WorksWelthMlSlornmter Projects\Harmony Oaks Mitigation Project%Construclion Contra"Idding and Construction Contract DocumenlslREVISED - 00456 - <br /> C Qualifications Queslionnalre.doc Rev. 05101 <br />