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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 : 9920 , 9810-A, 0545 <br /> Project Name : Roadway Improvements to 16th Street from 74th Avenue to 68th Avenue and <br /> 66 ' Avenue from 16 Street to S R 60 <br /> 1 . Bidder's Name / Address : W . C � ow ! h c, Y , L L L <br /> ------__7 3q Q f P 1 w P F 3 3 y / 3 <br /> 2 . Bidder's Telephone & FAX Numbers : j b 1 ) L1 -7 1 - Lt <br /> ItS 6 $ 3 t-, a? <br /> 3 . Licensing and Corporate Status: <br /> a . Is Contractor License current? �' G -5 <br /> b . Bidder's Contractor License No: _C (:; Cc I S- ut 6 [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: 33 Yea <br /> 5 . What is the last project OF THIS NATURE that the firm has completed? <br /> Gtr« VILw Qt, l - -�a - t0a " 13 z--; Cr " + <br /> Y <br /> 5 ✓IN1 " 4 qi� Pi- v6taL 1-L! � 1� <br /> 6 . Has the firm ever failed to complete work awarded to you? /y <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? N 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 liquidated damages have been assessed . ] <br /> 8 . Has the firm ever been charged by OSHA for violating any OSHA regulations? Na <br /> 00456 - Qualifications Questionnaire <br /> 00456 - i <br /> F^.engineering\Capital Pmjecls\9920-16th St, 74th Ave to 66th Ave19920 Contrad Documents 3 Specsl00456 - Qualifications Queobrtnaire.doo <br />