8-E. BID 21517 Affidavit of Compliance - Milw or American Made Goods, 20231211.pdf
PDF 79 KB Posted
- Solicitation number
- BID 21517
- Issued by
- Milwaukee County, Mattoon Village, Wisconsin
About this file
This is an Affidavit of Compliance form issued by the City of Milwaukee Department of Administration Purchasing Division for Bid #21517, which pertains to a vendor contract for 25' and 30' black bolt down aluminum poles. The contract will be awarded for a three-year period and must comply with City of Milwaukee Specification No. 12c-C-1 dated 10/30/2025 and Drawings #B-14-13 and #B-14-14 both dated 11/14/2014. Bidders seeking to qualify for the optional 12% Buy American bid incentive must submit this affidavit with their bid proposal. The form requires bidders to certify that supplied goods meet the criteria of City of Milwaukee-made, Milwaukee County-made, or American-made goods as defined in Milwaukee Code of Ordinances 310-18.9, with domestic components comprising more than 50% of the total cost of all components.
The affidavit requires bidders to declare under penalty of perjury the origin of their goods and to provide periodic reporting on job creation and retention if awarded the contract. Bidders must select only one classification category (City of Milwaukee-made, Milwaukee County-made, or American-made) and confirm that all items in each group meet the specified standard. The form explicitly prohibits bidders from receiving benefits under both the ordinance 310-18.9 incentive and the Local Business Enterprise program under Section 365-7-1. False, misleading, or fraudulent submissions may result in sanctions under Section 310-17-3-f. The affidavit must be authorized and signed by a company representative with printed name and date.
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Shared\Forms\Affidavit of Compliance - Milw or American Made Goods, 20231211
CITY OF MILWAUKEE - DEPARTMENT OF ADMINISTRATION
PURCHASING DIVISION
AFFIDAVIT OF COMPLIANCE
CITY OF MILWAUKEE, MILWAUKEE COUNTY, OR AMERICAN-MADE GOODS
IMPORTANT: This form must be submitted with your bid if you are seeking to quality for the 12% Buy American bid incentive. This bid incentive is optional not a requirement.
Bid #: 21517
Company:
Address:
City: State: Zip:
Location of Manufacturing Facility:
City: State:
This affidavit of compliance is the bidder’s sworn statement that the goods to be supplied meet the criteria of a
City of Milwaukee-Made, Milwaukee County-Made, or American-Made Good, as set forth in the Milwaukee
Code of Ordinances 310-18.9, as follows:
• City of Milwaukee-made Good - means an article that is manufactured, mined or produced in the City of
Milwaukee, and the cost of components made in Milwaukee used in the production of the good exceeds
50% of the total cost of all the components.
• Milwaukee County-made Good - means an article that is manufactured, mined or produced in
Milwaukee County, and the cost of the components made in Milwaukee County used in the production of the good exceeds 50% of the total cost of all the components.
• American-made Good - means an article that is manufactured, mined or produced in the United States, and the cost of domestic components used in the production of the good exceeds 50% of the total cost of all the components.
• Component - means an article, material or supply incorporated directly into an end product
If the multiple groups are being bid, all items in each group must be City of Milwaukee-made or Milwaukee
County-made or American-made to qualify.
NOTE: Any bidder proposing to supply goods under Ordinance 310-18.9 shall not also receive the benefit of the bid award provided under the Local Business Enterprise program in Section 365-7-1.
I hereby declare the goods to be supplied comply with Milwaukee Code of Ordinances 310-18.9 because the goods to be supplied are:
(Please check only one):
City of Milwaukee-made goods Milwaukee County-made goods American-made goods
Shared\Forms\Affidavit of Compliance - Milw or American Made Goods, 20231211
I understand and agree that if awarded a contract, I will provide periodic information to the Purchasing Division which will include, but may not be limited to, the estimated number of jobs created and retained.
I understand that any person, firm or corporation who is found to have submitted any false, misleading or fraudulent information or who fails to comply with the provisions of this section may be subject to the sanctions provided in Section 310-17-3-f.
Signature:
Printed Name: Date:
Current Job Information
Full
Time
Part
Time
Current number of employees:
If awarded a contract, our company anticipates the following number of jobs will be created If awarded a contract our company anticipates the following number of jobs will be retained
Authorized
Signature:
Printed Name: Date:
File details come from the government source that posted it. Updated .