HomeMy WebLinkAboutQualification Statement4.3. Qualification Statement (Page 1 of 2)
INSTRUCTIONS:
This questionnaire is to be 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:
COMPANY OFFICERS:
President
Secretary
t i4 14405
COMPANY OWNERSHIP:
EnRc.ni• A &xr Oempani
Vice President
A/4M ,Lev Inc
Treasurer rvn criyet cr
LICENSES:
10 0 % of ownership
% of ownership
% of ownership
% of ownership
1. County or Mur..icipal Occupational License No. 41 r oZ 6r]7 „ 0
(attach copy w5th bid)
2. Occupational License Classification o7r3 atiwicr % Ltc.a,n eiicr✓rCC
3. OccupationaI License Expiration Date:
9/3o/d oo6
4. Metro -Dade County Certificate of Competency No.
(attached copy if requested in Bid or RFP)
5. Social Security or Federal I.D. No. * S9 - /' V /21p
EXPERIENCE:
6. Number of Years your organization has been in business: 349
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: go
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: 3O
City of Miami Page 37
Bid No. 04-08-104
En-prt riSL
11-/1"q-t0 N. ILenekial\ LOS
, . 33l'11�
705- S`15.1313
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:
AGENCY/FIRM NAME/ADDRESS DATE(S) OF CONTRACT DESCRIPTION OF CONTRACT
il+ C.e,os t0,ee Tri be, o. .S tc e zioizoo I • , �. e �, • ae_e-
�nd"irohc p ortcLQ �2Sn 4c� �pv v� on �-erc-�2.�r`
13. O. Mo.�71 \t 0411L.33t4(4
CONTACT PERSON: Viet '1<-- �, WArrl Yljt0411
PHONE NO.: 1(30S) _ t(D00
AGENCY/FIRM NAME/ADDRESS DATE(S) OF CONTRACT DESCRIPTION OF CONTRACT
'
t .fix Q 1-kt vfl 9lP 'ate n-{
+eb.zoo -7..err\a1 -f oar Neti De()+„
CONTACT PERSON: -1-e. j-r lq eV Edo
PHONE NO,: (.30S)4\4,4900
AGENCY/FIRM
� NAME/ADDRESS DATE(S) OF CONTRACT�DESCRIPTION OF CONTRACT
C t� o MtIR{.i;- xideh1�P.-Thx,.zooD C.ehkt\ io+c- C.j# o PiM-6 -r1kAle(11k-
'- O() 1/) 2-"d PrVe. 3rai-k or
33ti3c
CONTACT PERSON: Ed d"t �9U e. PHONE NO.: c (0 --11'M
AGENCY/FIRM NAME/ADDRESS DATE(S) OF CONTRACT DESCRIPTION OF CONTRACT
+ade Ct tn\-•1 1-lkt i CaI t40), Zoo I Te nka1 -cqr Dr�ae Coon t WiPcliCa
aMiner 1,gMtn e[i I
\ 1)*" MinW .3313(c
CONTACT PERSON: le_sen1
ce,rrq PHONE NO.: 130E } S4 `-3 1 tp(fi
FAILURE TO FULLY COMPLETE, AND RFTURN THIS FORM MAY DISOUALIFY YOUR BID.
City of Miami Page 38
Bid No. 04-05.104
E rcke_rr o._ L2 S'i n c� (nmrr1
`14C}G N , 'Una \ fit'. Sub*e gos
-5oS- qkS•T3`13