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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 />prevented fiom bidding on, or completing, any government agency project for any reason? <br />❑ Yes ❑ No <br />If "yes," explain on a separate page. State the name of the organization debarred, the year <br />of the event, 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 <br />project, been filed 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 <br />claim, name of the claimant, the name of the entity the claim was filed against, a brief <br />description of the nature of the claim, the court and case member, and a brief description of <br />the status of the claim (pending or, if resolved, a brief description of the resolution.) <br />10. In the past five years, has your firm made any claim against a project owner concerning <br />work on a project 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 <br />claim, name of the claimant, the name of the entity the claim was filed against, a brief <br />description of the nature of the claim, the court and case member, and a brief description of <br />the status of the claim (pending or, if resolved, 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 <br />firm's behalf as a result of a default, to satisfy any claims made against a performance or <br />payment bond issued on yoiu firm's behalf in connection with a project, either public or <br />private? ❑ Yes ❑ No <br />12. In the last five years, has any insurance carrier, for any form of insurance, refused to renew <br />the insurance 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 <br />found guilty in a criminal action, for malting any false claim or material misrepresentation <br />to any public agency or entity? <br />❑ Yes ❑ No <br />City of Santa Ana Unarmed Security Guard Services RFP <br />25K-57 Page 53 <br />