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Home My WebLink AboutQuestionaire00500. SUPPLEMENT TO BID FORM: QUESTIONNAIRE THIS COMPLETED FORM SHOULD BE SUBMITTED WITH THE BID, HOWEVER, SUBMISSION OF THE FORM OR ANY ADDITIONAL INFORMATION NOT INCLUDED IN THE SUBMITTED FORM AS DETERMINED IN THE SOLE DISCRETION OF THE CITY, MAY BE SUBMITTED WITHIN SEVEN (7) CALENDAR DAYS OF THE CITY'S REQUEST. FAILURE TO SUBMIT THE FORM OR ADDITIONAL INFORMATION UPON REQUEST BY THE CITY SHALL RESULT 1N THE REJECTION OF THE BID AS NON -RESPONSIVE. The undersigned authorized representative of the Bidder certifies the truth and accuracy 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? License/Certification/Registration Name and Number # Y4ars Mort- L;o-*FG oa.73A Ocw a+ L►`t- �It7M7-s $F'h SfevUeS 1A. What business are you in? L_4, t t . 2. What is the last project of this nature that you have completed? bCp rwl Galotes (/firrba«cs 4-T (r 3. Have you ever failed to complete any work awarded to you? If so, where and why? 4. 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 was made. I iJO�L� 5. Give names, addresses and telephone numbers of three individuals, corporations, agencies, or institutions for which you have performed work: -overt et- ci L •es tp 853 mQif) 5 r-ect- 3(04 bI CO (name) (address) (phone #) (mobeilly -/kta...11.; LW 4 sW 2 AW-. (name) (address) (phone #) etc:C al4fo'+ d..• . aoX g82�S (Viame) (address) (phone #) Bid No. 05-06-059 Page 29 6. List the following information concerning all contracts in progress as of the date of submission of this bid. (In case of co -venture, list the information for all co -venturers.) TOTAL DATE OF % OF NAME OF OWNER & CONTRACT COMPLETION COMPLETION PROJECT PHONE # VALUE PER CONTRACT TO DATE (Continue list on insert sheet, if necessary.) 7. Has a representative of the Bidder completely inspected the proposed project and does the Bidder have a complete plan for its performance? Yes No 8. Will you subcontract any part of this Work? If so, provide the following details for each subcontractor(s) that will perform work in excess of ten percent (10%) of the contract amount. (Attach additional sheets if necessary) Subcontractor Approx. MIWBE Description of Work Name Percentage Status WEiel2 cac, 206 EleaCt- Ca uatab . (,j G ►j° q 6 g o0 0 37 7 The foregoing list of Subcontractor(s) may not be amended after award of the Contract without the prior written approval of the Contract Administrator, whose approval shall not be unreasonably withheld. 9. What equipment do you own that is available for the Work? ( 5 Cam''ck �c�s 055 E-c..L c,, erecte z krs 10. What equipment will you purchase for the proposed Work? Bid No, 05-06-059 Page 30 11. What equipment will you rent for the proposed Work? 12. State the name of your proposed project manager and superintendent and give details of his or her qualifications and experience in managing similar work. 61:0 Vet,cn L<<��tasitio t kus rrt>r - OJerSG.G ..) S40+•1 tti ar LaMt.d cc4 s £, 4t as 13ri,'c.k e f Co (IA le st . L . 6.0i- +5 13. State the true, exact, correct and complete name of the partnership, corporation or trade name under which 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 names of all partners. If a trade name, state the names of the individuals who do business under the trade narne). 13.1 The correct name of the Bidder is SP't f tj 13.2 The business is a (Sole Proprietorship) (Partnership) Cbrporatio . 13.3 The address of principal place of business is R7g:Q Nod 741¢ . 41i4a.n; vim/ 330 r4 13.4 The names of the corporate officers, or partners, or individuals doing business under a trade name, are as follows: CIA its Bid No. 05-06-059 Page 31 13.5 List all organizations which were predecessors to Bidder or in which the principals or officers of the Bidder were principals or officers. 13.6. List and describe all bankruptcy petitions (voluntary or involuntary) which have been filed by or against the Bidder, its parent or subsidiaries or predecessor organizations during the past five (5) years, Include in the description the disposition of each such petition. 13.7. List, and describe all successful Performance or Payment Bond claims made to your surety(ies) during the last five (5) years. The list and descriptions should include claims against the bond of the Bidder and its predecessor organization(s). 13.8 List all claims, arbitrations, mediations, civil actions, administrative hearings and lawsuits brought by or against the Bidder or its predecessor organization(s) during the last five (5) years. The list shall include all case names; case, arbitration or hearing identification numbers; the name of the project over which the dispute arose; a description of the subject matter of the dispute; and the final outcome of the claim. 13.9. List and describe all criminal proceedings or hearings concerning business related offenses in which the Bidder, its principals or officers or predecessor organization(s) were defendants. ®Ate. Bid No. 05-06-059 Page 32 13.10. Has the Bidder, its principals, officers or predecessor organization(s) been debarred or suspended from bidding by any government during the last five (5) years? If yes, provide details. 13.11. Under what conditions does the Bidder request Change Orders? c- p Sta� r 40 .ez r 1 13.12. What is the nature and amount of the three largest change orders submitted by the bidder within the past five years, and their disposition? &Jo✓LQ Bid No. 05-06-059 Page 33 00502. SUPPLEMENT TO BID FORM: CUSTOMER REFERENCE LISTING (Page 1 of 2) Contractors shall furnish the names, addresses, and telephone numbers of a minimum of five (5) firms or government organizations for which the Contractor has provided services for projects of similar size, scope and complexity over a three (3) year period. 44 1) Company Name 6. a CfRJ &cir`1 Address 7 O Si...) 72. Ave • Inik,-d J F(. 3 3 t5S-.. Contact Person/Contract Amount b.. /010;UO.S Telephone No. IFax No. Woo-513o 4400 - S-C 3 2) Company Name G+ Address q.t-l+-L Sk9 AG ..+•) Contact Person/Contract Amount El; (6 5ct /*L_,&7. Telephone No. /Fax No. 3Ps-`flb —17.33 i C 14 1.15 3) Company Name'' + Ate-. Address 6B53 4' vt ele.f / }»•�', F"� 3 �"'1 Contact PersonlContractAmount 144 c1S I4533.1581'l. Telephone No. IFax No. 3e5-- 364- (otDO /SSS/ w 1131/ 4) Company Name fl. 1 reelrc- 40r. svis it' 9 A 4 e. '. L�a�, 9. 3-x30r-( Address Contact Person/Contract AmountC.Vc,e _ ,.nple.kek or... Telephone No. IFax No. CiS i — CI.kSIC- Zlb9Fi /954-115;6-7b40 Bid No. 05-06-059 Page 34 00502. SUPPLEMENT TO BID FORM: CUSTOMER REFERENCE LISTING (Page 2 of 2) 5) Company Name wrG Address S Ob NW 1 O-7 4ue ! TeX) R • 3QZ I Contact Person/Contract Amountea.tAos b C/4u;000. Telephone No. /Fax No. ro5--5c72--2,2f ,% ---2c-V4g 6) Company Name Address Contact Person/Contract Amount Telephone No. IFax No. 7) Company Name Address Contact Person/Contract Amount Telephone No. /Fax No. 8) Company Name Address Contact Person/Contract Amount Telephone No. /Fax No. Bid No. 05-06-059 Page 35