HomeMy WebLinkAboutquestionnaire500. SUPPLEMENT MAID FORM:
501.
QUOTIONNAIR
THIS COMPLETED FORM SHOULD BE SUBMITTED WITH THE BI
HOWEVER, ANY ADDITIONAL INFORMATION NOT INCLUDED IN T
SUBMITTED FORM AS DETERMINED IN THE SOLE DISCRETION
THE CITY, SHALL BE SUBMITTED WITHIN SEVEN (7) CALENDAR DAY S:
OF THE CITY'S REQUEST.
The undersigned authorized representative of the Bidder certifies the truth and accurst*
of all statements and the answers=contained herein.
1, How many years has your organization been in business while possessing one Of
the licenses, certifications, or registrations specified in Section 00405?
License/Certification/Registration
cern:Z✓.. l Colt t 'v.,-
.
# Years
1A. What business are you in? (an steW
What is the last project of this nature, that you, have completed?
Have you ever failed to complete any work awarded to you? If so, where a
why?
Jo
}
Give owner names, addresses and telephone numbers , and surety and project
names, for all projects for which you have performed work, where your surety
has intervened to assist in completion of the project, whether or not a claim waif
made.
City of Miami
32
Bid No. 04-05-011
r
1
1
5. Give names, addresses and telephone numbers of three individuals, corporatiOnk
93 - -
(phontr)
(phon,I)
A-14-kdr,) ia,oart sfc.." —)
(name) (address) (phoni:ii)
agencies, or institutions for which you have performed work:
5.1. at.h.a._ A-roLaix
(name)
52. u 0.
(name)
5.3.
Sk-
(address)
3 5 +-
(address)
8. List the following information concerning all contracts in progress as of the dat4 of,
submission of this bid. (In case of co -venture, list the- information foralt
co -venturers.)
TOTAL DATE OF % OF
NAME OF OWNER & CONTRACT COMPLETION COMPLETION.
PROJECT PKONE # VALVE PER RONTRAQT TO DATE
42-4.
6,00-1A 4'44:2 set.
M.%/ r6-.1
Cr Oa, 1,4S-...3-7 2- t?
k.P4uug. Pi-co#Leo 3...t3UNe0 5.0 o'`‘. 31‘71". (- 0
(Continue list on insert sheet, if necessary.)
7. Has a representative of the BRIcler completely inspected the proposed_ project and
does the Bidder have a complete plan for its performance?
8. Will you subcontract any part of thls work? If so, give details including a listiof
each subcontractor(s) that will perform work in excess of ten percent (10%) of the
contract amount, the approximate percentage, and the work that will be performild
by each such subcontractor(s). Include the name of the subcontractor(s), MNVE1E
status and the approximate percentage of work. (Attach additional sheetty if
necessary)
G.e...e_re.t Pc s9
City of Miami
33 Ski No, 04-05-011
The foregoing Iist of subcontractor(s) may not be amended after award of i he
Contract without the priori written approval of the Contract Administrator, whc se _.
approval shall not be unreasonably withheld.
What equipment do you own that is available for the work?
?is s .
P -e rs i (2.0L1,4r5
10 What equipment will you purchase for the proposed work?
11. What equipment will you rent for the proposed work?
12. State the name of yourproposed project manager and superintendent and gr+t�e'
details of his or her qualifications and experience in managing similar work.
City of Miami
34 BId No. 04-05.011
t
13. State the true, exact, correct and complete name of the partnership, corpora on.
or trade name under whroh you do business and the address of the place{ of
business. (if a corporation, state the name of the president -.and secretary If a
partnership, state the navies of all partners. If a trade name, state the name of:
the individuals who do business under the trade name).
13.1
The correct namecf the Bidder is °+( -i-t0 twee,
13.2 The business is a (Sole Proprietorship) (Partnership) (Corporation).
13.3 The address of principal place of business is:
13.4 The names of _ the corporate officers, or partners, or individuals dot
business under a trade name, are as follows:
4A.(1f'-s ��� \fLy\.k
e., r1-4. Biota* t.r�� Sc art• s
13.5 List all organlzatioes which were predecessors to Bidder or In which the
principals or officers of the Bidder were principals or. officers. ;.
13.8. List and describe Ali bankruptcy petitions (voluntary or involuntary) whi h E
have been filed by or gthe Bidder, It
y againsts .parent or subsidiaries pr,
predecessor organizations during the past five (5) years. Include in t .,e;
description the dia4osition of each such petition.
t
5
.k
13.7. List and describe 411 successful Performance or Payment Bond clairris
made to your suriity(ies) during the last five (5) years. The list and
Clay of Miami _ 35 Bid No, 04.08.011
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