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CITY OF SANTA ANA
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<br />STREET SWEEPING SERVICES 51
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<br />8. In the last five years has your firm, or any firm with which any of your company’s owners, officers or
<br />partners was associated, been debarred, disqualified, removed or otherwise prevented from bidding
<br />on, or completing, any government agency or public works project for any reason?
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<br />Yes No
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<br />If “yes,” explain on a separate page. State the name of the organization debarred, the year of
<br />the event, the owner of the project, and the basis for the action.
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<br />9. In the past five years, has any claim against your firm concerning your firm’s work on a project,
<br />been filed in court or arbitration?
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<br />Yes No
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<br />If “yes,” on a separate page identify the claim(s) by providing the project name, date of the claim,
<br />name of the claimant, the name of the entity the claim was filed against, a brief description of the
<br />nature of the claim, the court and case number, and a brief description of the status of the claim
<br />(pending or, if resolved, a brief description of the resolution.)
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<br />10. In the past five years, has your firm made any claim against a project owner concerning work on
<br />a project or payment for a contract, and filed that claim in court or arbitration?
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<br />Yes No
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<br />If “yes,” on a separate page identify the claim(s) by providing the project name, date of the claim,
<br />name of the claimant, the name of the entity the claim was filed against, a brief description of the
<br />nature of the claim, the court and case number, and a brief description of the status of the claim
<br />(pending or, if resolved, a brief description of the resolution.)
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<br />11. At any time during the past five years, has any surety company made any payments on your
<br />firm’s behalf as a result of a default, to satisfy any claims made against a performance or payment
<br />bond issued on your firm’s behalf in connection with a project, either public or private?
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<br />Yes No
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<br />12. In the last five years, has any insurance carrier, for any form of insurance, refused to renew the
<br />insurance policy for your firm?
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<br />Yes No
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<br />13. Has your firm or any of its owners, officers, or partners ever been liable in a civil suit, or found
<br />guilty in a criminal action, for making any false claim or material misrepresentation to any public
<br />agency or entity?
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<br />Yes No
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<br />14. Has your firm or any of its owners, officers or partners ever been convicted of a federal or
<br />state crime of fraud, theft, or any other act of dishonesty?
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<br />Yes No
<br />If “yes,” identify on a separate page, the person or persons convicted, the court case and
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