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[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 />9. Has the firm ever been charged with noncompliance of any public policy or rules? <br />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.] <br />10. Attach to this questionnaire, a notarized financial statement and other information that <br />documents the firm's financial strength and history. "v& j I`Wew tfaWV re�`i`«sf' <br />11. Has the firm ever defaulted on any of its projects? <br />12 <br />13, <br />14. <br />15. <br />its <br />17 <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 a default occurred.] <br />Attach a separate page to this questionnaire that summarizes the firm's current <br />workload and that demonstrates its ability to meet the project schedule. <br />Name of person who inspected the site of the proposed work for the firm: <br />Name: S e ; c,1 Ho 1` 0"J SA mOl <br />Name of on-site Project Foreman: <br />Date of Inspections: <br />cc Civil a <br />C1/2 IV /a; <br />,j <br />Number of years of experience with similar projects as a Project Foreman: 5 <br />Name of Project Manager: M o c I" iv a s.S A � I <br />Number of years of experience with similar projects as a Project Manager: Z o <br />State your total bonding capacity: <br />3:%4 CA Cc 20a5 0mr 5 lit boeft> <br />State your bonding capacity per job: <br />"LK C54 Zo Pill IIloom de 114L�00 <br />18. Please provide name, address, telephone number, and contact person of your <br />5 u ,' [ p :C" S k *&&% ee Ce . <br />bonding company: <br />C N <br />$ Et /`+u i1 v 5d"• v (5o') 777- z e 9 4- <br />1#A4 C*,. C c0 0 A* s, N.Y. 13109 <br />[The remainder of this page was left blank intentionally] <br />00456 - Qualifications Questionnaire - REV 04-07 <br />00456-2 <br />FAEngineering\Capital Projects\080317th Lane SW Roadway Improvements from 27th Ave to approx. 900 LF east of 27th Ave\0803 Contract Documents\00456 - <br />Qualifications Questionnaire - REV 04-07.doc <br />