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Data Ticket, Inc. City of Santa Ana <br />Newport Beach, CA Request for Proposals for Automated <br />0: 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 />CITYOFANTAANA <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 Caltomia as a contractor under your present <br />business name and Iicenso number? _7 Xears <br />If you performed same business under a different business name with same ownership and operation <br />management and changed name clue to, but not limited to, bankruptcy, loss, or license, please complete <br />an additional and separate questionnaire. <br />2. What is your firms average gross revenue for the last three years? 5 8M <br />3. Is your I mh currently the debtor in a bankruptcy case? ❑ Yes [2 No <br />If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. <br />ase Num Ter an ptcy Court ate u <br />4. Was your fin in bankruptcy any time during the last five years? (This question refers onl to a <br />bankruptcy action that was not described in answer to Question 2, a w ve.) Yes M No <br />If"yes,° indicate the case number, bankruptcy court, and the date on which the petition was filed. <br />ass inn er an ruptcy urt ate t ed <br />5. Has any California State License Board license held by your firm or its responsible managing employee <br />or responsible managing officer beet) suspended within the last five years? Q 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? (] Yes Q No <br />7. Has your firm ever defaulted oil a contract? ❑ Yes 12 No <br />If 'yes,' explain on a separate page. <br />S. 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 from bidding on, <br />or completing, any government agency project for anyrsason? ❑ Yes [3 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 fimh concerning your firm's work on a project, been filed <br />in court or arbitration? © Yes IT 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 claimant, the name of Ole entity the claim was filed 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 Ann - AutgmateG Parking Ctmtian and Praseaatng 9arvicea (f2FP ir�.t te) <br />Page 7e <br />Proprietary and Confidential to Data Ticket, Inc. 311 P a 9 e <br />25G -55 <br />