22-00658-01-ST_BLR_12326.pdf
PDF 250 KB Posted
- Solicitation number
- FY2026-ITB-166
- Issued by
- Champaign County, Illinois
About this file
This is an Affidavit of Illinois Business Office form (BLR 12326) submitted by a bidder for the City of Urbana in Champaign County, Illinois, related to the Lincoln Avenue Complete Streets Demonstration project (Section 22-00658-01-ST). The affidavit serves as a statutory requirement under Section 30-22(8) of the Illinois Procurement Code and confirms that the bidder, if selected, will maintain a primary business office in Illinois that will serve as the principal place of employment for all personnel engaged in the construction work contemplated by the proposal. The project involves installing temporary traffic control measures and painting pavement marking lines and symbols on Lincoln Avenue from south of Wascher Drive to Killarney Street, and Bradley Avenue within the City of Urbana.
The affidavit requires the bidder's authorized officer or representative to be sworn and notarized, certifying their personal knowledge of the facts presented and their commitment to maintaining Illinois-based operations for the duration of the project. This document does not contain information regarding pricing, contract duration, funding sources, or other financial terms, as it functions solely as a compliance certification affirming the bidder's ability to meet the state's business office requirement for public construction projects.
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Text version
Affidavit of Illinois Business Office
Page 1 of 1 BLR 12326 (Rev. 01/20/23)Completed10/29/25
Local Public Agency
City of Urbana
County
Champaign
Street Name/Road Name
FAU 7177 / N. Lincoln Ave
Section Number
22-00658-01-ST
I, Name of Affiant of City of Affiant
State of Affiant being first duly sworn upon oath, state as follows:
1. That I am the Officer or Position of Bidder
2. That I have personal knowledge of the facts herein stated.
3. That, if selected under the proposal described above, Bidder
, will maintain a business office in the
State of Illinois, which will be located in County
County, Illinois.
4. That this business office will serve as the primary place of employment for any persons employed in the construction contemplated by this proposal.
5. That this Affidavit is given as a requirement of state law as provided in Section 30-22(8) of the Illinois Procurement Code.
Print Name of Affiant
Notary Public
Signed (or subscribed or attested) before me on
(name/s of person/s)
County
(SEAL) My commission expires
, authorized agent(s) of
(date) by
Bidder
State of IL
Notary Public Signature & Date
Signature & Date
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