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Data Ticket, Inc. City of Santa Ana <br />Newport Beach, CA Request for Proposals for Automated <br />O: 949 752-6937; F: 949 752-6033 Parking Citation and Processing Services <br />SECTION F: EXHIBIT G — RESPONSIBLE PROPOSER — SUBMITTAL <br />QUESTIONNAIRE <br />EXHIBIT G <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS FOR AUTOMATED PARKING CITATION AND PROCESSING SERVICES <br />RESPONSIBLE PROPOSER— SUPPLEMENTAL QUESTIONNAIRE <br />1. How many years has your organization been in business in Cafiforria as a contractor under your present <br />business name and license number?? 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 />3. Is your firm currently the debtor in a bankruptcy case? ❑ Yes ® No <br />If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. <br />ase NumberBankruptcy Court Date a Filed <br />4. Was your firm in bankruptcy anytime during the last five years? (This question refers onl to a <br />bankruptcy action that was not described in answer to Question2, above.) Yes ® No <br />If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. <br />Case umber SankrUptCY Court <br />5. Has any Califomia Slate License Board license held by your firm or its responsible managing em loyee <br />or responsible managing officer been suspended within the lastfive years? ❑ Yes No <br />6. At an time in the last five years, has your firm been assessed and paid liquidated damages after <br />completion of a project, under a services contract with either a public or private owner? [] Yes [ No <br />7. Has your firm ever defaulted on a contract? ❑ Yes W No <br />If "yes," explain on a separate page. <br />8. In the fast 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, <br />or completing, any government agency project for any reason? ❑ Yes IN 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 fimm's work oil a project, been filed <br />in court or arbitration? ❑ Yes 0 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 claunant, the name of the entity the claim was filer) 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 <br />City of Santa Ana — Automated Parking Citation and Processing Serviceo (RFP 1e-114) <br />Page 29 <br />Proprietary and Confidential to Data Ticket, Inc. 31 1 P a g e <br />