Affidavit of Eligibility Form - Buy Local or Veteran Small Business Program 12.25.pdf
PDF 2 MB Posted
- Attached to
- ECEP Cooling Tower Basin Improvements
- Solicitation number
- 146496
- Issued by
- Polk County, Florida
About this file
This is an Affidavit of Eligibility Form for the Buy Local or Veteran Small Business Program used by Florida state and local agencies, specifically applicable to solicitations in Orange, Osceola, Lake, Polk, and Seminole Counties. The form serves as a certification mechanism for businesses seeking preference consideration under either the Buy Local or Veteran Small Business Program. Businesses selecting the Buy Local designation must demonstrate that their headquarters, manufacturing facility, or principal office has been located within the jurisdictional boundaries of the specified counties for at least six months prior to solicitation issuance, or that the owner's primary residence is maintained within these boundaries. Alternatively, businesses qualifying under the Veteran Small Business Program must be owned and controlled by veterans as defined in Section 502 of the Veterans Benefits, Health Care, and Information Technology Act of 2006, be domiciled in Florida, and be listed in the federal Database of Veteran-owned Businesses.
Businesses submitting this form must provide supporting documentation appropriate to their selected program designation. Buy Local applicants must submit a physical business address (excluding post office boxes), a valid and current Local Business License Tax Receipt issued by an applicable local government, and any additional information requested by the district to verify local business status. Veteran Small Business Program applicants must provide proof that the business is a small business concern owned and controlled by veterans as defined by the aforementioned federal act. This affidavit form must be submitted with the bid response for all solicitations offering Buy Local or Veteran preference unless the business is already certified under one of these programs.
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Buy Local (or) Veteran Small Business Program
• The business owned and controlled by veterans as defined in Section 502 of the Veterans Benefits, Health Care, and Information Technology Act of 2006, as such may be amended from time to time, which business is also:
(i) domiciled in the State of Florida; and
(ii) listed in the federal Database of Veteran-owned Businesses.
• REQUIRED ATTACHMENTS:
o Proof the business is a small business concern that is owned and controlled by veterans as defined in Section 502 of the Veterans Benefits, Health Care, and Information Technology Act of 2006.
LOCAL BUSINESS (BUY LOCAL)
Business Information and Signature:
Affidavit of Eligibility Form
Submit this form with bid response for solicitations that have Buy Local or Veteran Preference if not already certified.
By signing below, I certify the Business meets the requirements for the type selected.
Business Type: ____________________________________________________________________________________
Business Name: __________________________________________________________________________________
Signature: _________________________________________________________________________________________
VETERAN SMALL BUSINESS
• The business has its headquarters, manufacturing facility, or principal office located or having a street address within the jurisdictional boundaries of Orange, Osceola, Lake, Polk, or Seminole County for at least six (6) months immediately prior to the issuance of the solicitation to which the business is responding; OR
• The Owner/Principal of the business maintains their primary residence within the jurisdictional boundaries of Orange, Osceola, Lake, Polk, or Seminole County.
• REQUIRED ATTACHMENTS:
o A physical business address (no post office boxes will be considered);
o A copy of a valid and current Local Business License Tax Receipt duly issued by a local government located within the jurisdictional boundaries of Osceola, Orange, Lake, Polk or Seminole County; and, o Any other information requested by the district that would verify local business status.
v 12.25
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| Business Type: [Select the Business Type (Preference)] |
File details come from the government source that posted it. Updated .