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EXHIBIT J <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS FOR JANITORIAL SERVICES <br />RESPONSIBLE PROPOSER —SUPPLEMENTAL QUESTIONNAIRE <br />1. How' many years has your organization been In business in. California as a contractor under your <br />present business name and license number? 8 years <br />Note: If you performed same business under a different business name with same ownership and <br />operation management and changed name due to, but not limited to, bankruptcy. loss, or license, <br />please complete an additional and separate questionnaire. <br />2. What is your firm's average gross revenue for the last three years? 5 2,425,367.96 <br />3. Is your firm Currently the debtor in a bankruptcy case? []Yes ®No <br />I.f'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 3, above.) []Yes ®No <br />If *Yes," indicate the case number, bankruptcy court, and the date on which the petition was tiled. <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 after <br />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? ❑ Yes 91 No <br />lt'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, officers or <br />partners was associated, been debarred, disqualified, removed, or otherwise prevented frorn <br />bidding on, or completing, any government agency project for any reason? ❑ Yes M No <br />Ii 'yes; explain on a separate page. State the name of the organization debarred, tite year of the <br />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 project, <br />been filed in court or arbitration? ❑ Yes ® No <br />If "yes," on a separate page identify the claim(s) by providing the project name, date of the claim. <br />name of the claimant, the name of the entity the claim was filed against, a brief description of the <br />nature of the claim, the court and case number, and a brief description of the status of the claim <br />(pending or, if resolved, a brief description of the resolution.) <br />Page 41 <br />PD Janitorial Services RPP I7•e22 <br />25D-87 <br />