7-7. REQUIRED Local Vendor Affidavit.docx
DOCX document 58 KB Posted
- Attached to
- Pavement Preservation Services
- Solicitation number
- IFB-028-26-RM
- Issued by
- Leon County, Florida
About this file
Local Vendor Affidavit for Pavement Preservation Services
This Local Vendor Affidavit document is required for vendors seeking location preference points in a pavement preservation services contract opportunity with the City of Tallahassee and the four-county area encompassing Leon, Wakulla, Gadsden, and Jefferson Counties, Florida. The project involves furnishing and applying bituminous surface treatments, commonly known as chip seal, which combines polymer-modified liquid asphalt emulsion with aggregate layers on paved roadways or prepared road bases in accordance with specifications established by the County.
To qualify for location preference points, vendors must meet all criteria of the "local business" definition, including maintaining a fixed office or distribution point with a street address in the four-county area for a minimum of six months prior to bid submission, holding all required business licenses from the four-county area, and employing at least one full-time employee or two part-time employees with primary residences in the region (or, for businesses with no employees, being at least fifty percent owned by local residents). Vendors must submit this completed affidavit with their proposal, providing current and prior local addresses if applicable, and copies of County and/or City business licenses. The purchasing agent retains sole discretion to verify local business status and may deny certification if required information is not provided. No specific contract term, award date, or pricing information is contained in this affidavit document.
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Other files
| File | Type | Posted |
|---|---|---|
| 1-1-1. REQUIRED IFB 028-26-RM REQUIRED IFB SECTIONS 123.docx | DOCX document | |
| 9-9. REQUIRED Vendor Conflict of Interest.docx | DOCX document | |
| 8-8 REQUIRED Responsible Vendor Review Form.docx | DOCX document | |
| 5-5. DRAFT CONTRACT CONSTRUCTION .doc | DOC document | |
| 2-2. REQUIRED BID SUMMARY.xlsx | XLSX spreadsheet | |
| 6-6. REQUIRED Representations Certifications.docx | DOCX document | |
| 4-4. REQUIRED Non Collusion Affidavit of Respondent.docx | DOCX document | |
| 3-3. REQUIRED HUMAN TRAFFICKING AFFIDAVIT.pdf |
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Text version
Local Vendor Affidavit
To qualify for Location points, a vendor must maintain a permanent place of business with full-time employees within Leon, Wakulla, Gadsden or Jefferson County, Florida, for a minimum of six (6) months prior to the date quotes are received. Local vendor must submit this Local Vendor Affidavit with their proposal for the preference.
The undersigned, as a duly authorized representative of the vendor listed herein, certifies to the best of his/her knowledge and belief, that the vendor meets the definition of a “Local Business.” For purposes of this section, "local business" shall mean a business which meets ALL below requirements:
a) Has had a fixed office or distribution point located in and having a street address within the four county area of Leon, Wakulla, Gadsden and Jefferson for at least six (6) months immediately prior to the submission of bids/quotes, to the City of Tallahassee, and
b) Holds any business license required by the four county area of Leon, Wakulla, Gadsden, and Jefferson (please attach copies); and
c) Employs at least one (1) full time employee, or two (2) part time employees whose primary residence is in the four county area of Leon, Wakulla, Gadsden, and Jefferson, or, if the business has no employees, the business shall be at least fifty percent (50%) owned by one or more persons whose primary residence is in the four county area of Leon, Wakulla, Gadsden, and Jefferson.
Please complete the following in support of the self-certification and submit copies of your County and/or City business licenses. Failure to provide the information requested will result in denial of certification as a local business.
Business/Company Name:
| Current Local Address: |
| Phone: ( |
| ) |
Fax: ( )
If the above address has been for less than six months, please provide the prior local address:
Length of time at this address:
| Home Office Address: |
| Phone: ( |
| ) |
Fax: ( )
NOTE: The purchasing agent shall not be required to verify the accuracy of any such certifications, and shall have the sole discretion to determine if a bidder meets the definition of a "local business."
Signature of Authorized Representative Print Name of Authorized Representative
Date Signed image1.jpeg
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