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CITY OF SANTA ANA <br /> <br />STREET SWEEPING SERVICES 50 <br /> <br /> <br /> <br /> <br /> <br /> <br />1. How many years has your organization been in business in California as a contractor under your <br />present business name and license number? <br /> Years <br /> <br />*If performed same business under a different business name with same ownership and operation <br />management and changed name due to, but not limited to, bankruptcy, loss or license, please <br />complete an additional and separate Questionnaire. <br /> <br />2. What is your firm’s Average Gross Revenue for the last three years? <br />$ <br /> <br />3. Is your firm currently the debtor in a bankruptcy case? <br /> <br />Yes No <br /> <br />If “yes,” indicate the case number, bankruptcy court, and the date on which the petition was filed. <br /> <br />Case Number Bankruptcy Court Date Filed <br /> <br />4. Was your firm in bankruptcy any time during the last five years? (This question refers only to a <br />bankruptcy action that was not described in answer to question 2, above.) <br /> <br />Yes No <br /> <br />If “yes,” indicate the case number, bankruptcy court, and the date on which the petition was filed. <br /> <br />Case Number Bankruptcy Court Date Filed <br /> <br />5. Has any California State License Board (CSLB) license held by your firm or its Responsible <br />Managing Employee (RME) or Responsible Managing Officer (RMO) been suspended or fined <br />within the last five years? <br /> <br />Yes No <br /> <br />6. At any time in the last five years, has your firm been assessed and paid liquidated <br />damages after completion of a project, under a construction contract with either a public or <br />private owner? <br /> <br />Yes No <br /> <br />7. Has your firm ever defaulted on a contract? <br /> <br />Yes No <br /> <br />If “yes,” explain on a separate page. <br />ATTACHMENT C – CONTINUE NEXT PAGE <br />ATTACHMENT C <br /> <br />RESPONSIBLE PROPOSER – SUPPLEMENTAL QUESTIONNAIRE