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EXHIBIT F CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR LED POST TOP RETROFIT STREETLIGHTS RESPONSIBLE PROPOSER — SUPPLEMENTAL QUESTIONNAIRE ma nvfin- orkmLt t. How many years has your organization been in business in California as a sokilraetor under your present, business name and license number? \os!�N `A, — 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. 2. What is ycurfirm's average gross revenue for the last three years? 3. 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 Bled, tie i � Case Number Bankruptcy Court Date Filed 4, Woe your firm in bankruptcy any time during the last five years? (rhis 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 data on which the petition was filed. 1�:AI A �A>� Case Bankruptcy Court Date Filed 5. Has any California State License Board license held by your firm or its responsible managing em loves or responsible managing officer been suspended wlthin the last five years? ❑Yes No S. At any time 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 19 No 7. Has your firm ever defaulted on a contract? ❑ Yes X 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 prevented from bicldin on, or cemplefing, any government agency project for any reason? E] Yes No If "yes," explain on a separate page. State the name of the organization debarred, the year of the event, the owner of the project, and the basis for the action. 9. In the past five years, has any claim against your firm concerning your firm's work on a project, been _filed in court or arbitration? El Yes X No If "yes," on a separate page identify the clalm(s) by providing the project name, date of the claim, name of the claimant, the name of the entity the claim was filed against, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, If resolved, a brief description of the resolution.) RFP FOR LED POST TOP RETROFIT STREETLIGHTS Page 22 20B -18 25D -36