Attachment D Local Vendor Preference.pdf

LOCAL BUSINESS PREFERENCE PROGRAM & AFFIDAVIT

THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED

TO ADMINISTER OATHS.

SECTION 1: GENERAL TERMS

The evaluation of competitive solicitations is subject to the City of Riviera Beach Code of Ordinances, Section 16.5, Article X – Preferences and Incentives Division 1 – Preferences for Local Vendors which, except where contrary to federal and state law, or any other funding source requirements, provides that preference be given to local businesses.

This preference shall apply to submittals received from offerors in the purchase of supplies or services in which objective factors are used to evaluate the submittals received from offerors are assigned point totals, a preference of five (5) percent of the total evaluation points, or five (5) percent of the total price, shall be given to a local business.

To satisfy this requirement, the business shall affirm in writing that it meets the following requirements:

1. Business must be located in the City of Riviera Beach with a current city business tax receipt and certificate of occupancy on AND;

2. Business must have a physical business location/address located within the City’s limits, from which the vendor operates or performs business on a day-to-day basis, that is a substantial component of the goods or services being offered to the City AND;

3. Business must certify in writing and provide all required documentation supporting its compliance with the foregoing at the time of submitting its bid or proposal by signing and notarizing this form.

Alternatively, a business who subcontracts at least twenty-five (25) percent of the contractual amount of a City project with subcontractors who meet the above listed criteria is deemed a Local Business for award of preference in accordance with Section 16.5 of the City of Riviera Beach Code of Ordinances. In the event that the prime Offeror utilizes sub-contractors to qualify for Local Business Preference, the Prime Offeror must also submit Statement of Intent Form with their submittal, along with this form.

Business location means a permanent office or other site where the local business conducts, engages in, or carries on all or a portion of its business. A post office box or location at a postal service center shall not constitute a business location.

The offeror, supplier, or contractor seeking the local business preference has the burden to show that it qualifies for the preference, to the satisfaction of the City.

Comparison of Qualifications: The preferences established in no way prohibit the right of the City to compare quality of supplies or services for purchase and to compare qualifications, character, responsibility and fitness of all persons, firms or corporations submitting bids or proposals. Furthermore, the preference established in no way prohibits the right of the City to give any other preference permitted by law instead of preferences granted, nor does it prohibit the City from selecting the submittal which is the most responsible and in the best interests of the City.

City of Riviera Beach, Florida

Procurement Department 1481 West 15th Street

Riviera Beach, FL 33404 Web: www.rivierabeach.org

Office: (561) 845-4180 Email: purchasing@rivierabeach.org http://www.rivierabeach.org/ mailto:purchasing@rivierabeach.org

SECTION 2: AFFIRMATION Failure to fully complete this affidavit and to submit the required supporting documents may render the Offeror ineligible for Local Preference. The Offeror must check the applicable box below:

□ Place a check mark here if the Bidder/Respondent meets the requirements listed below:

OR

□ Place a check mark here if the Bidder/Respondent is applying for Local Business Preference by subcontracting 25% or more of the contract amount to local subcontractors which meet the requirements listed below:

• Has a business located in the City with a current City Business Tax Receipt and certificate of use issued at least twelve (12) months prior to the City’s issuance of the Solicitation. (NOTE: A copy of applicable business tax receipt(s) and certificate(s) of use must be submitted along with this form)

• Has a physical business location/address located within the City’s limits, from which the vendor operates or performs business on a day-to-day basis that is a substantial component of the goods and services being offered to the City.

Offeror Certification: I certify that the information and responses on this form or attached hereto are true, accurate, and complete. I understand that the submittal of this form to the City’s Purchasing Department is for this public entity only.

I also understand that I am required to inform the City’s Procurement Department of any change in the information contained in this form or any attachments hereto.

(Company Name)

(Business Address)

(Signature of Authorized Representative) Title

(Print Name of Authorized Representative) Date

State of ___________________

County of __________________

The foregoing instrument was acknowledged before me this ______________ day of 20 __, by, ___________________ who is (who are) personally known to me or who has produced _________________as identification and who did (did not) take an oath.

Notary Public Signature

Notary Name, Printed, Typed or Stamped

Commission Number: ____________________ Commission Expires: ____________________

Subcontractor Certification (if applicable):

Type of Work to be Performed Percentage of Contract

I certify that the information and responses on this form or attached hereto are true, accurate, and complete. I understand that the submittal of this form to the City’s Procurement Department is for this public entity only. I also understand that I am required to inform the City’s Procurement Department of any change in the information contained in this form or any attachments hereto.

(Company Name)

(Business Address)

(Signature of Authorized Representative) Title

(Print Name of Authorized Representative) Date

State of ___________________

County of __________________

The foregoing instrument was acknowledged before me this ______________ day of 20 __, by, ___________________ who is (who are) personally known to me or who has produced _________________as identification and who did (did not) take an oath.

Notary Public Signature

Notary Name, Printed, Typed or Stamped

Commission Number: ____________________ Commission Expires: ____________________

NOTE: In the event that the Offeror is using more than one subcontractor to qualify for Local Business Preference, then each eligible subcontractor must also complete and certify page 3 of this form to be submitted by the Offeror as part of their proposal, along with the requisite supporting documents.

STATEMENT OF INTENT

SOLICITATION NO._____________

a partnership; □a corporation; □an individual; □a joint venture

A signed “Statement of Intent” shall be completed by both the proposer/bidder and the owner or authorized principal of each Local Business to provide services under this Solicitation.

________________________________ agrees to perform work on the above contract as (check one) Name of Local Business □

Local Business Contractor

The Local Business will enter into a formal agreement, conditioned upon the Bidder/Proposer executing a contract with the City of Riviera Beach for the work with ________________________________________.

Name of Bidder/Proposer

Item No.

Type of Work Agreed Price of Work Percentage of Work

1. $ %

2. $ %

3. $ %

TOTAL VALUE OF WORK $ %

Local Business Contact Name (Please Print) Title Date

Local Business Address, City, State & Zip Code

Local Business E-Mail address Phone Number Authorized Local Business Signature

Authorized Bidder/Proposer Signature Title Date

NOTE: A copy of the Local Vendor Business Tax Receipt, Certificate of Occupancy AND signatures of Local Business and Bidder/Proposer for each sub-contractor(s) listed above is required.