19C - RFP - CUSTODIAL SRVS AT CITY PARKS

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EXHIBIT G CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR PROVIDING PARK JANITORIAL MAINTENANCE SERVICES 1 2. 1911 RESPONSIBLE PROPOSER — SUPPLEMENTAL QUESTIONNAIRE How many years has your organization been in business in California as a contractor under your present business name and license number? If you performed same business under a different business name with same ownership and operation management and changed name due to, but not limited to, bankruptcy, loss, or license, please complete an additional and separate questionnaire. What is your firm's average gross revenue for the last three years? Is your firm currently the debtor in a bankruptcy case? ❑ Yes ❑ No If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. Case Number Bankruptcy Court Date Filed 4. Was your firm in bankruptcy any time during the last five years? (This question refers only to a bankruptcy action that was not described in answer to Question 2, above.) ❑ Yes ❑ No If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. Case Number Bankruptcy Court Date Filed 5. Has any California State License Board license held by your firm or its responsible managing employee or responsible managing officer been suspended within the last five years? ❑ Yes ❑ No 6. At anytime in the last five years, has your firm been assessed and paid liquidated damages after completion of a project, under a services contract with either a public or private owner? ❑ Yes ❑ No 7. Has your firm ever defaulted on a contract? ❑ Yes ❑ No If "yes," explain on a separate page. 8. In the last five years has your firm, or any firm with which any of your company's owners, officers or partners was associated, been debarred, disqualified, removed, or otherwise Park Janitorial Maintenance Services RFP 14 -002 Page 36 19C -38