APPENDIX I.doc

APPENDIX I

CONTRACTOR EXPERIENCE QUESTIONNAIRE AND FINANCIAL INFORMATION

INSTRUCTIONS PAGE

The information listed is required to be provided to the Florida Department of Agriculture and Consumer Services (FDACS) and included with Construction Management (CM) at Request for Statement of Qualifications (SOQ) proposal.

The identified Contractor or Firm is required to complete all Items 1-14. If the bidder or contractor is a Joint Venture, then each entity that is a party to the Joint Venture must individually complete this Questionnaire.

Project Number:

Project Name:

New Dundee citrus budwood greenhouses

Project Location:

820 lake mabel loop road, dundee, florida 33838

For CM at Risk the evaluators which are comprised of up to five (5) committee members will independently score category “Financial Capacity to Project Scope” listed under preliminary screening based upon information provided in Items 1-14, however, if needed, the Owner reserves the right to request your firm’s most recent “Financial Statement”.

1. Provide contractor corporate name as listed with the Department of State, Division of Corporation Listing on http://www.sunbiz.org/ or “sunbiz.org”.

2. Provide requested Business Structure information.

3. Provide Annual Construction Gross Revenue for previous five (5) years.

4. Provide firm’s Current Bonding Capacity.

5. Provide Business Name information.

6. List number of full-time personnel within your organization.

7. Provide Subsidiary or Affiliated companies financial involvement information.

8. Identify construction management personnel experience for your organization.

9. Identify your organization or predecessor organizations failure to complete a project contract.

10. Identify if your organization has been involved in litigation.

11. List the most recent ten (10) contracts completed by your organization.

12. Explain the differences in final contract price and/or scheduled completion dates.

13. Identify any liquidated damages, penalties, liens, defaults or cancellations imposed or filed.

14. Provide contract information currently under construction.

DIRECTIONS: Items 1 through 14 must be fully completed on the following pages or marked “Does Not Apply” for any non-pertinent Item(s).

If additional space is required, please attach supplementary pages.

CONTRACTOR EXPERIENCE QUESTIONNAIRE AND FINANCIAL INFORMATION

(Continued)

1.

Firm Name:

Proposed Office Address:

Contact Name and Telephone Number:

Contact Email Address:

The contractor acknowledges that this Contractor Experience Questionnaire and Financial Information are made for the express purpose of inducing the Florida Department of Agriculture and Consumer Services (FDACS or Owner) to award a contract to the contractor. Further, the contractor acknowledges that the agency may at its discretion, by means which the Owner may choose, determine the truth and accuracy of all statements made by the contractor herein. If needed, the Owner reserves the right to request your most recent Financial Statement.

2.

Business Structure: (List firm names if Partnership or Joint Venture)

Proprietorship

Corporation

Joint Venture

Partnership

If owned by a parent company, provide parent company name:

Please provide copy of State of Florida Corporate Registration:

If Corporation answer below:

If Joint Venture or Partnership, answer below:

Date of Incorporation:

Date of organization:

In what State:

Firms Involved:

Name of Corporate Officers:

President:

Vice President:

Secretary:

Treasurer:

3.

Annual Construction Gross Revenue for Previous Five (5) Years:

Year

CONTRACTOR EXPERIENCE QUESTIONNAIRE AND FINANCIAL INFORMATION

(Continued)

4.

Firm’s Current Bonding Capacity:

Per Project Limit:

Per Aggregate Limit:

5.

How many years has your organization been in the construction business?

B.

How many years under your present business name:

C.

How many years under previous business name:

(List other names):

3.

6.

Number of full time personnel within your organization:

Current

A. Executive Administrators

B. Preconstruction Managers and Estimators

C. Construction Project Managers

D. Field Superintendents and Foremen

E. Other Field Construction Employees

F.

Administrative Assistants

G. Total number of full time personnel

7.

Subsidiary or affiliated companies which Principal(s) have financial interest and list nature of business:

1.

3.

4.

(Continued)

8.

Identify construction management personnel experience for your organization.

(Highlight personnel likely to be assigned to project being bid or solicited)

Name:

Title:

Years with firm / years in construction 1.

2.

3.

4.

5.

9.

Within previous five (5) fiscal years has your organization or predecessor organizations ever failed to complete a project. If so, state name of organization and reason thereof.

1.

2.

3.

4.

5.

10.

Within previous five (5) fiscal years has your organization been involved in litigation with your client? If so, please list and explain nature and current status.

1.

2.

3.

4.

(Continued)

11. List the most recent ten (10) contracts completed by your organization:

Construction Duration Completion Dates

(Continued)

With reference to ten (10) most recently completed contracts, as listed on Page 5, answer the following questions:

12.

Explain the differences in final contract price and/or scheduled completion dates.

13.

Were there any liquidated damages, penalties, liens, defaults or cancellations imposed or filed?

If so, list the name and location of the project and why rejected from bidding?

14.

Provide contract information currently under construction as requested below. (Use seven largest dollar value) A

Project Description Location & Owner B

Design Professional C

Total Contract Amount D

Uncompleted Contract Amount E

Scheduled Substantial Completion Date

Total: