Affidavit of Eligibility Form - Buy Local or Veteran Small Business Program 12.25.pdf
PDF 2 MB Posted
- Attached to
- Lift Station #46 Rehabilitation
- Solicitation number
- 145242
- 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 required for bidders responding to solicitations that include Buy Local or Veteran preference provisions and must be submitted with the bid response unless the business is already certified. Bidders must select and certify their business type under either the Local Business (Buy Local) category or the Veteran Small Business category, providing their business name and authorized signature.
Eligibility requirements vary by program category. Local businesses must have their headquarters, manufacturing facility, or principal office located within the specified county jurisdictions for at least six months prior to solicitation issuance, or alternatively, the owner or principal must maintain their primary residence within these jurisdictional boundaries. Veteran small businesses must be owned and controlled by veterans as defined in Section 502 of the Veterans Benefits, Health Care, and Information Technology Act of 2006 and be domiciled in Florida while listed in the federal Database of Veteran-owned Businesses. Required attachments include proof of small business status for veteran-owned businesses, a physical business address (excluding post office boxes), a valid and current local business license tax receipt issued by the respective county government, and any additional documentation requested by the district to verify business eligibility status.
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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: |
| Button11: |
| Business Type: [Select the Business Type (Preference)] |
File details come from the government source that posted it. Updated .