LOCATION CERTIFICATION

REQUEST FOR PROPOSAL, REQUEST FOR QUALIFICATION, OR REQUEST FOR LETTER OF INTEREST

To Be Eligible for Local Preference: (refer to Instructions to Vendors if applicable to the solicitation) The Vendor should submit this fully completed form and all Required Supporting Documentation (as indicated below) by solicitation end date. If not provided with submittal, the Vendor must submit within three business days after County’s written request. Failure to submit required forms or information by stated timeframes may deem the Vendor ineligible for local preference or points for location.

To be eligible for the ‘Location’ tiebreaker: (refer to Instructions to Vendors if applicable to the solicitation) The Vendor must submit this fully completed form and a copy of its Broward County local business tax receipt by solicitation end date. Vendors who fail to comply with this submittal deadline will not be eligible for the location tiebreaker.

Broward County Code of Ordinances, Section 1-74, et seq., provides certain preferences to Local Businesses, Locally Based Businesses, and Locally Based Subsidiaries, and the Broward County Procurement Code provides location as the first tiebreaker criteria. The undersigned Vendor hereby certifies that (check the box for only one option below):

☐ Option 1: The Vendor is a Local Business, but does not qualify as a Locally Based Business or a Locally Based Subsidiary, as each term is defined by Section 1-74, Broward County Code of Ordinances. The Vendor further certifies that:

A. It has continuously maintained, for at least the one (1) year period immediately preceding the bid posting date (i.e., the date on which the solicitation was advertised),

i. a physical business address located within the limits of Broward County, listed on the Vendor’s valid business tax receipt issued by Broward County (unless exempt from business tax receipt requirements),

ii. in an area zoned for the conduct of such business,

iii. that the Vendor owns or has the legal right to use, and

iv. from which the Vendor operates and performs on a day-to-day basis business that is a substantial component of the goods or services being offered to Broward County in connection with the applicable competitive solicitation (as so defined, the “Local Business Location”).

If Option 1 selected, indicate Local Business Location:

☐ Option 2: The Vendor is both a Local Business and a Locally Based Business as each term is defined by Section 1-74, Broward County Code of Ordinances. The Vendor further certifies that:

A. The Vendor has continuously maintained, for at least the one (1) year period immediately preceding the bid posting date (i.e., the date on which the solicitation was advertised),

i. a physical business address located within the limits of Broward County, listed on the Vendor’s valid business tax receipt issued by Broward County (unless exempt from business tax receipt requirements),

ii. in an area zoned for the conduct of such business,

iii. that the Vendor owns or has the legal right to use, and

iv. from which the Vendor operates and performs on a day-to-day basis business that is a substantial component of the goods or services being offered to Broward County in connection with the applicable competitive solicitation as so defined, the “Local Business Location”).

B. The Local Business Location is the primary business address of the majority of the Vendor’s employees as of the bid posting date, and/or the majority of the work under the solicitation, if awarded to the Vendor, will be performed by employees of the Vendor whose primary business address is the Local Business Location;

C. The Vendor’s management directs, controls, and coordinates all or substantially all of the day-to-day activities of the entity (such as marketing, finance, accounting, human resources, payroll, and operations) from the Local Business Location;

D. The Vendor has not claimed any other location as its principal place of business within the one (1) year period immediately preceding the bid posting date; and E. Less than fifty percent (50%) of the total equity interests in the business are owned, directly or indirectly, by one or more entities with a principal place of business located outside of Broward County. The Vendor certifies that the total equity interests in the owned, directly or indirectly, by one or more entities with a principal place of business Vendor located outside of Broward County is __ %.

If Option 2 selected, indicate Local Business Location:

☐ Option 3: The Vendor is both a Local Business and a Locally Based Subsidiary as each term is defined by Section 1-74, Broward County Code of Ordinances. The Vendor further certifies that:

A. The Vendor has continuously maintained:

i. for at least the one (1) year period immediately preceding the bid posting date (i.e., the date on which the solicitation was advertised),

ii. a physical business address located within the limits of Broward County, listed on the Vendor’s valid business tax receipt issued by Broward County (unless exempt from business tax receipt requirements),

iii. in an area zoned for the conduct of such business,

iv. that the Vendor owns or has the legal right to use, and

v. from which the Vendor operates and performs on a day-to-day basis business that is a substantial component of the goods or services being offered to Broward County in connection with the applicable competitive solicitation (as so defined, the “Local Business Location”).

B. The Local Business Location is the primary business address of the majority of the Vendor’s employees as of the bid posting date, and/or the majority of the work under the solicitation, if awarded to the Vendor, will be performed by employees of the Vendor whose primary business address is the Local Business Location;

C. The Vendor’s management directs, controls, and coordinates all or substantially all of the day-to-day activities of the entity (such as marketing, finance, accounting, human resources, payroll, and operations) from the Local Business Location;

D. The Vendor has not claimed any other location as its principal place of business within the one (1) year period immediately preceding the bid posting date; and E. At least fifty percent (50%) of the total equity interests in the business are owned, directly or indirectly, by one or more entities with a principal place of business located outside of Broward County. The Vendor certifies that the total equity interests in the Vendor owned, directly or indirectly, by one or more entities with a principal place of business located outside of Broward County is ____%.

If Option 3 selected, indicate Local Business Location:

Street Address: Click or tap here to enter text.

City, State, Zip: Click or tap here to enter text.

☐ Option 4: The Vendor is a joint venture composed of one or more Local Businesses, Locally Based Businesses, or Locally Based Subsidiaries, as each term is defined by Section 1-74, Broward County Code of Ordinances. Fill in blanks with percentage equity interest or list “N/A” if section does not apply. The Vendor further certifies that:

A. The proportion of equity interests in the joint venture owned by Local Business(es) (each Local Business must comply with all of the requirements stated in Option 1) is __________% of the total equity interests in the joint venture; and/or B. The proportion of equity interests in the joint venture owned by Locally Based Business(es) (each Locally Based Business must comply with all of the requirements stated in Option 2) is ___________% of the total equity interests in the joint venture; and/or C. The proportion of equity interests in the joint venture owned by Locally Based Subsidiary(ies) (each Locally Based Subsidiary must comply with all of the requirements stated in Option 3) is ___________% of the total equity interests in the joint venture.

If Option 4 selected, indicate the Local Business Location(s) on separate sheet.

☐ Option 5: Vendor is not a Local Business, a Locally Based Business, or a Locally Based Subsidiary, as each term is defined by Section 1-74, Broward County Code of Ordinances.

Required Supporting Documentation (in addition to this form):

Option 1 or 2 (Local Business or Locally Based Business)

1. Broward County local business tax receipt.

Option 3 (Locally Based Subsidiary)

1. Broward County local business tax receipt.

2. Documentation identifying the Vendor’s vertical corporate organization and names of parent entities.

Option 4 (joint venture composed of one or more Local Business(es), Locally Based Business(es), or Locally Based Subsidiary(ies):

1. Broward County local business tax receipt(s) for each Local Business(es), Locally Based Business(es), and/or Locally Based Subsidiary(ies).

2. Executed joint venture agreement if the Vendor is a joint venture.

3. If joint venture is comprised of one or more Locally Based Subsidiary(ies), submit documentation identifying the vertical corporate organization and parent entities name(s) of each Locally Based Subsidiary.

If requested by County (any option):

1. Written proof of the Vendor’s ownership or right to use the real property at the Local Business Location.

2. Additional documentation relating to the parent entities of the Vendor.

3. Additional documentation demonstrating the applicable percentage of equity interests in the joint venture, if not shown in the joint venture agreement.

4. Any other documentation requested by County regarding the location from which the activities of the Vendor are directed, controlled, and coordinated.

By submitting this form, the Vendor certifies that if awarded a contract, it is the intent of the Vendor to remain at the Local Business Locations listed above, if any (or another qualifying Local Business Location within Broward County), for the duration of the contract term, including any renewals or extensions.

True and Correct Attestations:

Any misleading, inaccurate, or false information or documentation submitted by any party affiliated with this procurement may lead to suspension and/or debarment from doing business with Broward County as authorized by the Broward County Procurement Code. The Vendor understands that, if after contract award, the County learns that any of the information provided by the Vendor on this form was false, and the County determines, upon investigation, that the Vendor’s provision of such false information was willful or intentional, the County may exercise any contractual right to terminate the contract. The provision of false or fraudulent information or documentation by a Vendor may subject the Vendor to civil and criminal penalties.

Vendor Name: Click or tap here to enter text.

Signature: ______________________________ Printed Name: Click or tap here to enter text.

Title: Click or tap here to enter text.

Date: Click or tap to enter a date.

Form Date 9/9/24