[A]_Local_Preference_Affidavit.pdf
PDF 114 KB Posted
- Attached to
- Annual Paving, Drainage and Concrete
- Solicitation number
- ITB 25-086
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
This document is a Company Affidavit form for the City of Fort Myers and Lee County, Florida, designed to verify a company's local office status and eligibility for local preference points during a proposal submission process. The affidavit requires companies to demonstrate they have a valid Business Tax License issued by Lee County at least six months prior to proposal submission, with a physical business address within Lee County's limits. The form provides a scoring mechanism where companies can earn points based on their office location: 5 points for an office within Fort Myers city limits, 3 points for an office within Lee County boundaries, and 0 points for no local office.
The document outlines specific requirements for companies seeking to claim local preference, including the need to document in-County/in-office capabilities and personnel availability. Companies must complete detailed sections providing their legal registration name, state of registration, headquarters and local office addresses, federal tax ID, and Lee County Business Tax Number. The affidavit includes a notarization section where the company representative swears to the truthfulness of the information, with a warning that misrepresenting local preference status will result in losing local preference privileges for one year. The form must be signed, dated, and include a notary public's official seal to be considered valid.
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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.
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