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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 on, or
<br />completing, any government agency or public works project for any reason?
<br />? Yes ? No
<br />If "yes," explain on a separate page. State the name of the organization debarred, the year of the event,
<br />the owner of the project, and the basis for the action.
<br />9. In the past five years, has any claim against your firm concerning your firm's work on a project, been filed
<br />in court or arbitration?
<br />? Yes ? No
<br />If "yes," on a separate page identify the claim(s) by providing the project name, date of the claim, name of
<br />the claimant, the name of the entity the claim was filed against, a brief description of the nature of the
<br />claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved,
<br />a brief description of the resolution.)
<br />10. In the past five years, has your firm made any claim against a project owner concerning work on a project
<br />or payment for a contract, and filed that claim in court or arbitration?
<br />? Yes ? No
<br />If "yes," on a separate page identify the claim(s) by providing the project name, date of the claim, name of
<br />the claimant, the name of the entity the claim was filed against, a brief description of the nature of the
<br />claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved,
<br />a brief description of the resolution.)
<br />11. At any time during the past five years, has any surety company made any payments on your firm's behalf
<br />as a result of a default, to satisfy any claims made against a performance or payment bond issued on your
<br />firm's behalf in connection with a project, either public or private?
<br />? Yes ? No
<br />12. In the last five years, has any insurance carrier, for any form of insurance, refused to renew the insurance
<br />policy for your firm?
<br />? Yes ? No
<br />13. Has your firm or any of its owners, officers, or partners ever been liable in a civil suit, or found guilty in a
<br />criminal action, for making any false claim or material misrepresentation to any public agency or entity?
<br />? Yes ? No
<br />14. Has your firm or any of its owners, officers or partners ever been convicted of a federal or state crime of
<br />fraud, theft, or any other act of dishonesty?
<br />? Yes ? No
<br />If "yes," identify on a separate page, the person or persons convicted, the court case and number, the
<br />crimes and the year convicted.
<br />25H-61
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