4-007 Affidavit of Eligibility.pdf
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- Attached to
- 26003721 Fire Hydrants for U25-01
- Solicitation number
- 26003721
- Issued by
- Mason County, Texas
About this file
This is an Affidavit of Eligibility form issued by the City of Midland, Texas, for consideration of bidders whose principal place of business is located within the city limits. The form applies to bids ranging from $50,000 to $100,000 for services and up to $500,000 for commodities. Bidders seeking local preference consideration must complete and submit the affidavit to Erika Martinez, Purchasing Manager, at the City of Midland's offices located at 300 N. Loraine Street, PO Box 1152, Midland, TX 79702-1152. The form requires bidders to provide their local business name and address within city limits, confirm whether the listed address is their principal place of business, disclose the number of City of Midland residents employed at that location, and state the year the business was established in the city.
The affidavit requires submission of reseller permit information if applicable, disclosure of multiple office locations within Texas, and confirmation of business and real property tax payment obligations to the City of Midland for the most recent tax year. Pursuant to Texas Local Government Code 271.9051, if a local bidder's price falls within five percent of the lowest bid received from a non-local bidder, the City Council may award the contract to the local bidder based on a determination that the local option provides the best combination of contract price and additional economic development opportunities, including local employment and increased tax revenues. Bidders submitting false information face a one-year prohibition from bidding on City of Midland products and services. Incomplete affidavits may be rejected.
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Text version
X:\WPDOCS\FORM\PrefAfft.doc Revised: 10/17/2011
CCCIIITTTYYY OOOFFF MMMIIIDDDLLLAAANNNDDD
Consideration of Location of Bidder's Principal Place of Business
For Bids of $50,000 up to $100,000 for Services and $500,000 for Commodities Affidavit of Eligibility
Pursuant to Texas Local Government Code 271.9051, in purchasing real property, personal property that is not affixed to real property, or services, if the City receives one or more bids from a bidder whose principal place of business is in the City of Midland and whose bid is within five percent (5%) of the lowest bid price received by the City from a bidder who is not a resident of the City of Midland, the City may enter into a contract with:
(1) the lowest bidder; or
(2) the bidder whose principal place of business is in the City of Midland if the City Council determines, in writing, that the local bidder offers the City the best combination of contract price and additional economic development opportunities for the City of Midland created by the contract award, including the employment of residents of the City of Midland and increased tax revenues to the City of Midland.
In order to receive consideration, bidders must submit this affidavit to:
Erika Martinez Purchasing Manager City of Midland 300 N. Loraine St., PO BOX 1152
Midland, TX 79702-1152
Complete all areas below. Incomplete affidavits may be rejected.
Local Business Name:
Local Address (must be within the City limits):
1. Is the above address the principal place of business for the business named above? Yes No
2. How many residents of the City of Midland are employed at the above business location?
3. Year your business was established in the City of Midland:
4. If you collect sales tax for ANY class of customer, provide the following Reseller information:
Reseller Permit Number:
Company Name and Address (as it appears on permit):
5. Does your business have more than one office in the State of Texas? Yes No If Yes, identify the office location considered as the point-of sale for the purpose of sales tax calculation:
6. Was the local business required to pay business and/or real property tax for the most recent tax year?
Yes No
If Yes, did the local business pay any of this tax to the City of Midland? Yes No
Under penalty of perjury, the undersigned states that the foregoing statements are true and correct. It is further acknowledged that any person, firm, corporation or entity intentionally submitting false information to the City in an attempt to qualify for eligibility shall be prohibited from bidding on City of Midland products and services for a period of one (1) year.
Authorized Signature: Date:
Printed Name and Title:
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