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PEST CONTROL SERVICES <br />RFB PWD 24.408 <br />Page | 8 <br />CONTRACTOR INFORMATION <br />(Required) <br /> <br />CONTRACTOR: <br />(Company Name) <br />Year <br />Est.: <br /> <br /> <br />BUSINESS ADDRESS: <br />WEBSITE: <br />LICENSE(S) #: <br />SUBMITTED BY: <br /> <br />Name: <br />Title: <br />TELEPHONE: Office: <br />Cell: <br />EMAIL: Email: <br />Email: <br /> <br /> <br />Questionnaire (please circle): <br />1. Has the contractor license been suspended in the past? (If Yes, please explain) <br /> Yes No If, Yes__________________________________________ <br />2. Do you have any contracts terminated by Owner in the past? (If Yes, please explain) <br /> Yes No If, Yes__________________________________________ <br />3. Has the company been debarred or suspended by Owner in the past? (If yes, please <br />explain) Yes No If, Yes__________________________________________ <br /> <br /> <br />SIGNATURE: DATE: <br /> <br />PRINT NAME: TITLE: <br /> <br /> <br />I declare under penalty of perjury that I have the authority to execute this bid and that the <br />foregoing is true and correct. <br /> <br /> <br /> <br />    <br /> <br /> <br />Torpedo Pest Control <br />www.torpedopestcontrol.com <br />PO Box 1339, <br />Atwater, CA 95301 <br />OPR 14344 <br />Don Hyler <br />Owner/Operator <br />209-445-3090 <br />209-445-3090 <br />donh@torpedopestcontrol.com <br />1998 <br />Don Hyler <br />05/09/2024 <br />Owner/Operator <br />DocuSign Envelope ID: 16D1C412-7260-4260-8A87-C870C0BEE374