3-Local Preference Affidavit 05.09.2023.pdf

IEHP Local Preference 05.09.2023

Local Business Qualification Affidavit

Inland Empire Health Plan (IEHP) has adopted a local preference program to be used when evaluating quotations submitted from firms or individuals engaged in “for profit” business activities paid for in “whole” or “in part” out of IEHP General Funds. The IEHP Local Business Preference of 5 points may be applied to a bidder’s bid submission if the bidder qualifies for this preference. Potential Bidders, please submit this form along with your bid response if claiming the preference.

Definition of a Local Business A local business shall mean a business/firm with fixed offices located within the geographical boundaries of Riverside and San Bernardino Counties, authorized to perform business within these two counties, and in doing so, credit all sales tax from sales generated within Riverside or San Bernardino County. Vendors who provide product or perform contracted work using employees, of whom the majority are physically located in said local offices located within the County boundaries, might claim the Local Preference of 5 points.

“Local businesses” must have a Riverside or San Bernardino County business street address. Post office box numbers, residential addresses or unstaffed sales offices shall not suffice to establish status as a “local business”. To qualify as a “local business” the location must be open and staffed during normal business hours and the business must establish proof that it has been located and doing business in Riverside or San Bernardino County for at least (6) six months preceding its certification to IEHP as a local business.

Additional supporting documentation requested by IEHP to verify qualification includes:

1. A copy of a current BOE 531-A and/or BOE 530-C form: (State, Local & District Sales and Use Tax Return Form). Businesses submit this form to the State Board of Equalization when paying the sales tax to the State of California indicating the amount of their tax credits to each jurisdiction (i.e., Counties, Cities).

2. A current business license is required for the political jurisdiction the business is located.

3. Proof of the current business address: The local business needs to be operating from a functional office that operates and has staffing of the company’s employees, during normal business hours. A residential address will not suffice.

Business name:

Physical address:

Phone: Cell: E-Mail:

Length of time at this location: Number of company employees at this address:

If less than 6 months, list previous location(s)

County location: Riverside San Bernardino

Business license # (where applicable): Hours of operation:

Primary function of this location (i.e., sales, distribution, production, corporate, etc):

Signature of Company Official/Title Date

IEHP Local Preference

Each proposal will receive scoring for each category being evaluated as demonstrated below. The qualified local business will receive 5 points for “Local Preference” towards their overall score.

Example:

Criteria Possible Score

Bidder #1 (Local)

Bidder #2 (Non-Local)

Overall Cost 95 95 95 Local Preference 5 5 0

Grand Total 100 100 95

Awarded Bidder

Definition of a Local Business