1-LOCAL BIDDER PREFERENCE CERTIFICATION FORM.pdf
PDF 90 KB Posted
- Attached to
- Deicer
- Solicitation number
- 2026-61
- Issued by
- Union County, Kentucky
About this file
This is a Local Bidder Preference Certification Form issued by the City of Bowling Green, Kentucky, for use in connection with a state and local contract opportunity for an enhanced highway deicing salt product. The form requires bidding companies to certify their eligibility for local preference status at the time of bid submission. Bidders must provide their registered company name, City Registration ID, business address, property zone type, and confirm current compliance with City financial obligations. The certification process involves verification by City staff and the Occupational License Division to confirm the accuracy of submitted information and the bidder's eligibility for local preference consideration.
To qualify for local bidder preference, a business entity must not be delinquent on property taxes, net profit fees, occupational withholdings, or liens and fines owed to the City of Bowling Green. Additionally, the bidder must have paid the City a combined total of $2,500.00 or more in property taxes, net profit fees, or employee withholdings during the previous fiscal year. The certification must be signed by an official representative of the bidding company under penalty of perjury. City staff will verify all required information before granting local preference status, and no preference will be awarded if the certification form is not submitted with bid documents or if the City cannot verify eligibility based on the information provided.
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Text version
Local Bidder Preference Certification
It shall be the responsibility of the local business entity to certify eligibility for local preference status in writing at the time any bid is submitted, if local preference is applicable. No preference shall be granted if this certification is not provided with the bid documents or if City staff is unable to verify eligibility based on the information provided to the City. The local business entity acknowledges that City staff may need to verify eligibility by accessing confidential information filed with the City.
A. Bidding Company Name (Registered with the City) ________________________________
B. City Registration ID# __________________ Date of Registration _____________________
C. Address of place of business: __________________________________________________
D. List the property zone type for business location: ___________________________________
E. Are you currently delinquent on any of the following to the City of Bowling Green:
Delinquent property taxes ___ Net profit fees ___ Occupational withholdings ___ Liens or fines ___
F. Did you pay to the City of Bowling Green $2,500.00 or more combined in any of the following fees and taxes during the previous fiscal year?
Property Taxes ___ Net Profit Fees ___ Employee Withholdings ___
Comments:
The undersigned hereby certifies that to the best of his knowledge and belief, the information submitted herein is accurate, complete and current as of this date.
Official Name (Printed) _________________________________________________
Official Signature _________________________________________________
Date Signed _________________________________________________
For Official Use Only
Date forwarded to Occupational License Division (Verification of A, B, C, E and F) _____________________ Upon completion, please return to Procurement Manager.
Verification of A, B, C, E and F: Approved _____ Not Approved _____ Comment _________________________________________________________________________________ Signature____________________________________ Date ______________________________________
Verification of D: Approved _____ Not Approved _____ Comment _________________________________________________________________________________ Signature____________________________________ Date ______________________________________
| Date of Registration: |
| Verification of A B C E and F Approved: |
| Date: |
| Verification of D Approved: |
| Bidding Company Name Registered with the City: |
| City Occupational License #: |
| Address of place of business: |
| List the property zone type for business location: |
| Delinquent property taxes: Off |
| Net profit fees: Off |
| Occupational withholdings: Off |
| Liens of fines: Off |
| Property Taxes: Off |
| Net Profit Fees: Off |
| Employee Withholdings: Off |
| Comments Box: |
| Official Name Printed: |
| Official Signature: |
| Date Signed: |
| Date forwarded to Occupational License Division: |
| Verification of A B C E and F Not Approved: |
| Verification of D Not Approved: |
| Procurement Manager Signed Date: |
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