Affidavit of Eligibility Form - Buy Local or Veteran Small Business Program 12.25.pdf
PDF 2 MB Posted
- Solicitation number
- 143529
- Issued by
- Polk County, Florida
About this file
This is an Affidavit of Eligibility Form for the Buy Local or Veteran Small Business Program applicable to state and local contract opportunities in Florida, specifically for jurisdictions including Orange, Osceola, Lake, Polk, and Seminole Counties. The form is used to certify business eligibility for preference consideration in solicitations that include Buy Local or Veteran preferences. Bidders must submit the completed form with their bid response if they are not already certified. The document outlines two distinct eligibility pathways: the Veteran Small Business designation, which requires the business to be owned and controlled by veterans as defined in Section 502 of the Veterans Benefits, Health Care, and Information Technology Act of 2006, with the business domiciled in Florida and listed in the federal Database of Veteran-owned Businesses; and the Local Business designation, which requires the business headquarters, manufacturing facility, or principal office to be located within the specified county jurisdictions for at least six months prior to solicitation issuance, or the owner's primary residence to be located within those same boundaries.
Businesses seeking certification must provide specific documentation to substantiate their eligibility status. For Veteran Small Business designation, applicants must submit proof that the business is a small business concern owned and controlled by veterans as defined in the applicable federal statute. For Local Business designation, applicants must provide a physical business address (post office boxes are not acceptable), a copy of a valid and current Local Business License Tax Receipt issued by a local government within the specified county jurisdictions, and any additional information requested by the district to verify local business status. The related contract opportunity identified is for Mowing and Weed Control Services for Rapid Infiltration Basins, with the explicit requirement that contractors shall not subcontract any part of the work.
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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
| Business Name: |
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| Business Type: [Select the Business Type (Preference)] |
File details come from the government source that posted it. Updated .