Affidavit of Eligibility Form - Buy Local or Veteran Small Business Program 12.25.pdf
PDF 2 MB Posted
- Attached to
- 2027 Milling and Resurfacing Project
- Solicitation number
- 146156
- Issued by
- Polk County, Florida
About this file
This is an Affidavit of Eligibility Form for the Buy Local or Veteran Small Business Program in Florida, specifically related to the 2027 Milling and Resurfacing Project. The form applies to businesses seeking preference consideration in state and local solicitations within Orange, Osceola, Lake, Polk, or Seminole County jurisdictions. Businesses must submit this affidavit with their bid response if they have not already obtained certification. The form requires bidders to select their business type and provide their business name and signature, certifying that they meet the requirements for the designated preference category.
Two preference categories are available under this program. Local businesses must maintain their headquarters, manufacturing facility, or principal office within the specified five-county jurisdictional boundaries for at least six months prior to the solicitation issuance, or the owner/principal must maintain their primary residence within these boundaries. Veteran-owned 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 and listed in the federal Database of Veteran-owned Businesses. Local business applicants must provide a physical business address, a valid and current Local Business License Tax Receipt from the appropriate county government, and any additional verification documentation requested by the district. Veteran-owned business applicants must provide proof of veteran ownership and control status. Award for the underlying 2027 Milling and Resurfacing Project will be based on the lowest bidder pricing for the base bid.
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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 .