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Qualification Statement Part 1 <br />The undersigned certifies under oath the truth and correctness of all statements and all answers to questions made hereinafter: <br />Company Profile <br />Response <br />Name of Company <br />Bettoli Trading Corp. D/B/A Bettoli Vending <br />Address <br />6095 NW 167th street Suite D4 <br />City <br />Hialeah, <br />State <br />Florida <br />Zip <br />33015 <br />Telephone Number <br />305-626-0740 <br />Fax Number <br />305-623-0108 <br />How many years has your organization been in business <br />under its present name? <br />20 <br />Under what former name(s) has your business operated? <br />J&H Vendors <br />At what address was that/those business(es) located? <br />Same <br />Are you a: sales representative, distributor, broker, or <br />manufacturer, of the commodities/services bid upon? <br />Yes <br />Qualification Statement Part 2 <br />Note: if you are providing the Local Vendor Preference Form, you can do so through the Document Upload area under the "Local Vendor Preference Form" upload area. All <br />Certifications can be uploaded to the "Certification for Qualification" area. <br />Bid Number: RFP 2021-03 Vendor Name: Bettoli Trading C 595 <br />Response* ` <br />Additional Information, if required <br />Are you operating under Fictitious Name ("dba")? If Yes, submit <br />r Yes <br />http://dos.sunbiz.org/scripts/ficidet.exe? <br />evidence of compliance with Florida Fictitious Name Statute. <br />r No <br />action=DETREG&docnum=G10000054470&rdocn <br />um=610000054470 <br />Are you Certified? If Yes, ATTACH A COPY OF CERTIFICATION <br />r Yes <br />This certification is not require for shelf stable <br />r No <br />product, However, if the city prefers that we <br />hold a certification, we have no problem <br />completing the process. <br />Are you Licensed? If Yes, ATTACH A COPY OF LICENSE <br />r Yes <br />r No <br />Are you claiming Minority Participation, as per Section 2.22? (If yes, <br />C. Yes <br />please complete Local Vendor Preference Form) <br />r No <br />Are you claiming Local Preference, as per Section 2.23? <br />r Yes <br />r No <br />Do you have the required insurance coverage's set forth in the <br />r Yes <br />competitive solicitation? If Yes, ATTACH A COPY OF INSURANCE <br />r No <br />CERTIFICATES <br />Has your company or you personally ever declared bankruptcy? If Yes, <br />r Yes <br />explain? <br />r No <br />Have you ever received a contract or a purchase order from the City <br />r Yes <br />of Parkland or other governmental entity? If yes, explain (date, <br />r No <br />service/project, bid title, etc.): <br />Have you ever received a complaint on a contract or bid awarded to <br />r Yes <br />you by any governmental entity? If yes, explain: <br />r. No <br />Have you ever been debarred or suspended from doing business with <br />r- Yes <br />any governmental entity? If yes, explain: <br />r No <br />Bid Number: RFP 2021-03 Vendor Name: Bettoli Trading C 595 <br />