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EXHIBIT G <br />CITY OF SANTA <br />ANA <br />REQUEST FOR PROPOSALS FOR PROVIDING PARK JANITORIAL MAINTENANCE <br />SERVICES RESPONSIBLE PROPOSER — SUPPLEMENTAL QUESTIONNAIRE <br />t. How many years has your organization been in business in California as a contractor under <br />your present business name and license number? 33 years <br />If you 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 complete <br />an additional and separate questionnaire. <br />2. What is your firm's average gross revenue for the last three years? <br />$ 5.8 million a year <br />3. Is your firm currently the debtor in a bankruptcy case? <br />❑ Yes ❑ No <br />If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. <br />Case Number Bankruptcy Court Date Filed <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 />❑ Yes ❑ No <br />If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. <br />Case Number Bankruptcy Court Date Filed <br />5. Has any California State License Board license held by your firm or its responsible managing <br />employee or responsible managing officer been suspended within the last five years? <br />❑ Yes ❑ No <br />6. At any time in the last five years, has your firm been assessed and paid liquidated damages <br />after completion of a project, under a services contract with either a public or private owner? <br />❑ Yes ❑ No <br />7. Has your firm ever defaulted on a contract? <br />❑ Yes ❑ No <br />If "yes," explain on a separate page. <br />8. In the last five years has your firm, or any firm with which any of your company's owners, <br />officers or partners was associated, been debarred, disqualified, removed, or otherwise <br />Park Janitorial Maintenance Services RFP 14-002 Page <br />36 <br />EXHIBIT A <br />