8._LOCAL_PREFERENCE_AFFIDAVIT.pdf
PDF 114 KB Posted
- Attached to
- SCADA On Call Continuing Services
- Solicitation number
- GEN 0025-24-RFQ
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
This document is a Company Affidavit form from the City of Fort Myers, Florida, designed to verify a company's local office status and personnel location for a contract opportunity. The form requires companies to provide details about their business location, with specific points awarded based on whether the office is located within the City of Fort Myers (5 points), within Lee County (3 points), or outside the county (0 points). Companies must have a valid Business Tax License issued by Lee County at least six months prior to proposal submission and demonstrate in-county/in-office capability and personnel availability.
The affidavit includes sections for documenting the legal registration name, headquarters and local office addresses, federal tax ID, and Lee County Business Tax Number. Companies must complete the form and provide supporting documentation to be eligible for local preference consideration. The document warns that misrepresenting local preference status will result in losing the privilege to claim local preference for one year, and failure to provide requested documentation may render the proposal non-responsive. The form must be notarized and signed, with the signee guaranteeing the truth and accuracy of the provided information.
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Text version
Company Affidavit
Notarized Affidavit
This Form must be completed and returned by the Prime Firm
Proposer affirms that information provided as it relates to Location & Facilities of Working Office is true and meets the definition and criteria as defined below:
Local office means the company has a valid Business Tax License issued by Lee County at least six (6) months prior to the proposal submission. This affirms the company has a physical business address from which to operate or perform business that is located within the limits of Lee County thus authorizing the company to conduct business with the City of Fort Myers. Post Office Boxes are not verifiable and shall not be used for the purpose of establishing said physical address.
Companies must demonstrate and document the in-County/in-office capability and availability of the personnel and the type of services performed at this location that is pertinent to the type of project. Companies shall affirm in writing their compliance with the foregoing at the time of proposal submission to be eligible for consideration as having a “Local Office”. A company who misrepresents the local preference status of its company in a proposal to the City will lose the privilege to claim local preference for a one-year period.
Please place a checkmark next to the appropriate criteria and related points. Provide supporting documentation with this affidavit as the City of Fort Myers reserves the right to request supporting documentation as evidence to substantiate the information given in this affidavit. Failure to do so will result in the proposer’s submission being deemed non-responsive.
Section 1: Office Location
Prime Firm must check appropriate spaces. Note: Points in this section will be applied to the Prime only during selection scoring process.
Criteria Points Bidder Check Off
Office located within the Limits of the City of Fort Myers 5
Office not located within the City Limits, but is, located in boundaries of Lee County 3
No office located within the Limits of the City of Fort Myers or the boundaries of Lee County 0
Section 2: Location and Team Personnel associated with this project
*Personnel Affidavit attached to be completed by each person living in Lee County
Legal Registration Name of Firm: ______________________________________________________________________
State of Registration: _______________________________________________________________________________
Headquarters Address
Street: ______________________________________________City/State/Zip: ________________________________
Local Office Address if different than Headquarters
Street: ______________________________________________City/State/Zip: ________________________________
Federal Tax I.D. Number: _______________________________Lee County Business Tax Number _________________
Printed Name and Title: _____________________________________________Signature________________________
State of Florida
County of _______________________________
Sworn to and subscribed before me, a Notary Public, for the above State and County on this _____________day of __________________________, 20_______.
Notary Public Commission Expiration
(Affix Official Seal)
The signee of this Affidavit guarantees, as evidenced by the sworn affidavit required herein, the truth and accuracy of this affidavit to interrogatories hereinafter made.
File details come from the government source that posted it. Updated .