6-Local Preference Consideration - Application.pdf

PDF 59 KB Posted

Attached to
Stop Loss Reinsurance for Partially Self-Funded Medical and Prescription Health Plans
Solicitation number
HR-01-26
Issued by
Travis County, Texas

About this file

This document is a Local Preference Consideration Application from the City of San Angelo, Texas Purchasing Division, located at 72 West College Avenue in San Angelo. The form is designed for vendors seeking local preference in city contract opportunities, requiring detailed information about the vendor's potential economic impact on the city. Vendors must provide their business details, vendor type (corporation, partnership, or sole proprietorship), and attach supporting documentation describing the additional economic development opportunities they would create if awarded the contract.

The application requires vendors to specify the number of San Angelo residents they would employ and the projected increase in tax revenues for the city. Vendors must certify under penalty of perjury that the information provided is accurate and that they are authorized to sign the document. The form includes a certification statement and spaces for an authorized agent to print their name, title, provide a signature, and date the application, demonstrating the city's commitment to transparency and local economic development in its procurement process.

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Text version

CITY OF SAN ANGELO, TEXAS

PURCHASING DIVISION

72 West College Avenue, San Angelo, Texas 76903

325.657.4219 • sapurch@cosatx.us

CITY OF SAN ANGELO, TEXAS • LOCAL PREFERENCE CONSIDERATION

Local Preference Consideration Application

Vendor Name:

Physical Address:

Mailing Address:

City, State, Zip Code:

Vendor Type:

Corporation – Indicate state of incorporation Partnership – Indicate “general” or “limited” Sole proprietorship

Attachments:

Describe in writing, and attach supporting documentation, the additional economic development opportunities for the City of San Angelo that will be created if you are awarded this contract. Include the number of City of San Angelo residents that you will employ to complete this contract and the increased tax revenues that will be generated for the City of San Angelo if you are awarded this contract.

Certification:

I hereby certify under penalty of perjury that the information which I have provided on this form is true and correct, that I am authorized to sign on behalf of the vendor set out above and if requested by the city will provide, within 10 days of notice, the necessary documents to substantiate the information provided.

AUTHORIZED AGENT • PLEASE PRINT

VENDOR

NAME TITLE

SIGNATURE

DATE

mailto:sapurch@cosatx.us

Local Preference Consideration Application

File details come from the government source that posted it. Updated .