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EXHIBIT J <br />O OF SANTA ANA <br />REQUEST FOR PROPOSALS FOR JANITORIAL SERVICES <br />ESPONSIRI F PRO OS R —5t1P MENTAL OUESTIONNAIR <br />1. Now many years has your organization been in business in. California as a contractor under your <br />present business narne and license number? sB years <br />Note: If you performed same business under a different business name with same ownership and <br />operation management and changed name duo to, but not limited to, bankruptcy, toss, 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? $_ 221367.96 <br />3. is your firm currently the debtor in a bankruptcy case? LlYes ONO <br />if "yes,' indicate the caso number, bankruptcy court, and the date on which the petition was tiled. <br />Case Number Bankruptcy Court-Ciate Filed <br />4Was your firm In bankruptcy any time during the lest five years? (This question refers only to a <br />bankruptcy action that was not described in answer to Question 3, above.) ❑Yes NINa <br />If ^yes," fndicate the case number, bankruptcy court, and the date on which the petition was filed. <br />Case Number Bankruptcy t sort Date Flied <br />s. 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 />CIYas [KNo <br />6, At any time in the last five years, has your firm been assessed and {said liquidated damages attar <br />completion of a project, under a services contract with either a public or private owner? <br />)Yes MNo <br />7, Has yourfirm ever defaulted on a contract? r-'J Yes � No <br />it "yes," explain on a separate page, <br />8. In the last five years has your firm, or ally firm with which any of your company's owners, officers or <br />partners was associated, been debarred. disqualified, removed, or otherwise prevented from <br />bidding on, or completing, any government agency project for any reason? Q Yes tX No <br />If "yes," explain on a separate page. State the name of the organization debarred, tine year of the <br />event, the Owner of the project, and the basis for the action. <br />g. In the pest five years, has any claim against your firm concerning your firms work on a project, <br />been filed in court or arbitration? D Yes M Na <br />It "yes," on a separate page identify the claim(sj by providing the project r€ame, 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 at 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 nc <br />PD Janilwal Serviros RFP t7.022 <br />