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� ��\ �� �� !S � 14 Appendix A Questions 1 through 9 apply to the General Contractor. Questions 10 through 12 apply to the individual the Contractor proposes to act as the engineer of record for the project. Contractor will be immediately disqualified if the answer to any of questions 1 through 5 and 10 through 11 is "no."� Contractor will be immediately disqualified if the answer to any of questions 6, 7, 8, 9, or 12 is "yes." If the answer to question 8 is "yes," and if debarment would be the sole reason for denial of pre-qualiticarion, any pre-qualification issued will exclude the debarment period. 1. Contractor possesses a valid and current California Contractor's license for the project or pmjects for which it intends to submit a bid. ❑ Yes ❑ No 2. Contractor has a liability insurance policy with a policy limit of at least $1,000,000 per occurrence and $2,000,000 ag8regate. ❑ Yes ❑ No 3. Contractor has current workers' compensation insurance policy as required by the Labor Code or is legally self-insured pursuant to Labor Code secrion 3700 et. seq. ❑ Yes ❑ No ❑ Contractor is exempt from this requirement, because it has no employees 4. Have you attached your latest copy of a reviewed or audited financial statement with accompanying notes and supplemental information. ❑ Yes ❑ No NOTE: A financial statement that is not either reviewed or audited is not acceptable. A letter verifying availability of a line of credit may also be attached; however, it will be considered as supplemental informarion only, and is not a substitute for the required financial statement. � A"no" answer to Question 4 wiil not be disqualifying if the contractor is exempt from complying with Question 4, for reasons explained in footnote 3. Z A contractor disqualified solely because of a"Yes" aoswer given to question 6, 7, or 9 may appeal the disqualification and provide an explanation of the relevant circumstances during the appeal procedure. } Public Contract Code section 20101(e) exempts &om this requirement a contractor who has qualified as a swall business pursuant to Govemment Code secBon 14837(d)( I), if the bid is "no more than 25 per cent of the qualifying amount provided in section 14837(d)(I)." As o£January 1, 2001, the qualifying amount is $10 million, and 25 per cent of tl�at amount, therefore, is $2.5 millioa Pege 13 W 28 zm