HomeMy WebLinkAboutQualification Statement 74.3. Qualification Statement (Page lof 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: J! ,✓FYI 61.41,41 '' ''Nr'` s LL(
COMPANY OFFICERS:
President -70.004.A.
/ '" L � Vice PresidentIL
Secretary Treasurer ` `
COMPANY OWNERSHIP:
oerA1- f AC/ FIX/'4/
/ IL' % of ownership
% of ownership
% of ownership
% of ownership
LICENSES:
1. County or Municipal Occupational License No. 4 /)...'1"(11 3 3 r 4 p ei , y
(attach copy with bid)
2. Occupational License Classification t„r!1 0 i ! 441 j C. — t, jtt ~'rZ 5
3. Occupational License Expiration Date: ?%/ T o/c -6
4. Metro -Dade County Certificate of Competency No.
(attached copy if requested in Bid or RFP)
5. Social Security or Federal I.D. No.
del 2 2—
EXPERIENCE:
6. Number of Years your organization has been in business: l5--
7. Number of Years experience BIDDER/$ROPOSER (person, principal of firm, owner) has had in operation
of the type required by the specifications of the Bid or RFP: Z- 0
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: 22
City of Miami Page 27
Bid No. 45-06434
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 wii:h in the past three (3) years:
AGENCY/FIRM NAME/ADDRESS
DATE OF CONTRACT DESCRIPTION OF CONTRACT
(3RowMb co. Sc-MRtfel offtcf. apak.. ORES
S S. a< I Avid
pr.Aso otDArI4., Jr'(. 3336/
CONTACT PERSON: .Scrr ,Di aEdmcWR
AGENCY/FIRM NAME/ADDRESS
E ,. SA/SrrKc GA c' IVEM) 41C
tat nt I O4 c¶ f S A 'a4MiD
PHONE NO.: "SDI ^ $131-00
DATE OF CONTRACT DESCRIPTION OF CONTRACT
w5-1114 Dilk (Wom �99f•Pr Pastor DEsiJ £4 t s-r c�F
3g51 So. ac gk�tA j}+<. cai/$ 4jj oftftA - W
,t fv colW ir�+A , 3 300 SrWj1 t PA,i ik, Pam# r i ire
CONTACT PERSON: TYVV414 P91v(G.
AGENCY/FIRM NAME/ADDRESS
B ocA r r,J ims T f ct,tI$
roth- Rmu), F'Le 3k3 i
PHONE NO.: 4 54 60. UM
DATE OF CONTRACT DESCRIPTION OF CONTRACT
204)0- PAsF,,dr DE.scc„' Tittit xNsWimp?) a
144 yttojkill4 snort . pJamst
rtork Gtvf PitcttN6
CONTACT PERSON: t3rti CAM
AGENCY/FIRM NAME/ADDRESS
Risiktqlk. PAtm Jag
Pf iltAe4t. R. 'jitt4Q
CONTACT PERSON: j'(.N W1Sk
PHONE NO.: c(01 �14i- 3433
DATE OF CONTRACT DESCRIPTION OF CONTRACT
I SL- P ItAsb+i Dare,N 3i t i , rvsr +Nfl+►f c,F
At . i, 4A It sf *Now- pot N�
�ni�tt,� su*s. - r tsJ, 44, , ,n
PHONE NO.: 91 Gil 1124
FAILURE TO FULLY COMPLETE. AND RETURN THIS FORM MAY DISQUALIFY YOUR BID,
City of Miami
Bid No. 05-08-034
Page 28