HomeMy WebLinkAboutQualification Statement4.3. Qualification Statement
INSTRUCTIONS:
This questionnaire is to he included with your bid. Do not leave any questions unanswered. When the question
does not apply, write the word(s) "None", or "Not Applicable", as appropriate. Please print.
COMPANY NAME: GavNw442CAA40 &Nitg.Cr1( SPL?C. Atc, Ls -Gs, NC
COMPANY OFFICERS:
President r01.VAILO 6, ✓tA€NOoZ4 Vice President 43/avwteS E• vKrtc.HELL
Secretary V 12.41 141At M. 1411►1t•+,.t"LA Treasurer l41 LA ICY IY+AtE LOv ZA
COMPANY OWNERSHIP:
4.VAItc% 6 mallool.R
4.0 % of ownership
% of ownership
% of ownership
% of ownership
LICENSES:
1. County or Municipal Occupational License No. 44W5 13304 3
(attach copy with bid)
2. Occupational License Classification (70O — 4 v -Lnow►A'>C %ova 5'I5 %Q Iili-R..
3. Occupational License Expiration Date: 5 C.P"l'w'"‘ heit-- 3O, ' m C 40
4. Metro -Dade County Certificate of Competency No. i•t JA
(attached copy if requested in Bid or RFP)
5. Social Security or Federal I.D. No. '51 C 5S O O S 7
EXPERIENCE:
b. Number of Years your organization has been in business: 93
7. Number of Years experience BIDDER/PROPOSER (person, principal of firm, owner) has had in operation
of the type required by the specifications of the Bid or RFP: 47S
8. Number of Years experience BIDDER/PROPOSER (firm, corporation, proprietorship) has had in
operation of the type required by the specifications of the Bid or RFP: c).1
City of Miami Page 26
Bid No. 05-06-024
Bid Response Form — Qualification Statement (Page 2 of 2)
9. Experience Record: List references who may be contacted to ascertain information on past and/or present
contracts, work, jobs, that BIDDER/PROPOSER has performed of a type similar to that required by
specifications of the City's Bid or RFP with whom you have done business with in the past three (3) years:
FIRM NAME/ADDRESS DATE OF JOB DESCRIPTION OF JOB
W1.1 ,t'trw\ I 0,413 L Cry WI-ICS 4-12 C-
,1L3 . et3.21�I g S - 34t:) I 5 . 3 • 04 A .
wnJhvtt lit- 3-SI'3"L.
CONTACT PERSON: Q M NY iafN'soN
FIRM NAME/ADDRESS DATE OF JOB
5upPy C.t-IrrvK,41..10
r,butPWT `Lb PoDt_S.
e.b.cTY cocomurr Cove eAatc. Or(o IN4
11 -D P2R-ii.4C eESS fizAO
A)4T iSoc 44,°tg
CONTACT PERSON: NSI L CAT.* PA No
FIRM NAME/ADDRESS DATE OF JOB
crry Imo. t.*LA,Oe.,2aALE ONdoiNG
C+Fr 21 &Z- +PAR-K -- 114 so W . S A N ? LSe 15L f
F`r 2WAL. )'13311
CONTACT PERSON: Std2 4t4 }.I€ L ccic-
FIRM NAME/ADDRESS DATE OF JOB
PHONE NO. C,Ict,.6 733 - 31
DESCRIPTION OF JOB
5wPPLy cl-kcmLC L efe4O
E.4t,tt PrAet(T -a 'ooL ..
PHONE NO.EgoI);-7L -/140
DESCRIPTION OF JOB
Sw!'PLY Ci-11,wtc,4LSS /etQCD
i=ut repAckrr POoLs ,
GITy s&A—ci- _ ot1/4ItboIN4
VL.C1+4^ t t.l a c PA -LC... - RI 1 t 1't
vh, t ( isc is j . 33 134i
CONTACT PERSON: W4 ( &,.Cr 4 6 R.AS dh1
PHONE NOC.% - 53$fQ
DESCRIPTION OF JOB
stAePLV •41,1O
ecuAt Pw.tst•I-r Poot-
PHONE No.(7 g 717 - qs, 13
FAILURE TO FULLY COMPLETE, AND RETURN THIS FORM MAY DISOUALIFY YOUR BID.
City of Miami
Bld No. 05-06-024
Page 27