Attachment_E_SMC_Local_Preference_Self-Attestation_Form.pdf
PDF 92 KB Posted
- Attached to
- Structured Cabling and Installation Services
- Solicitation number
- RFP ISD-20261906
- Issued by
- San Mateo County, San Bernardino City, California
About this file
This is a Local Preference Self-Attestation Form issued by the County of San Mateo, California, for use in response to the Structured Cabling and Installation Services solicitation (RFP #ISD-20261906). The form enables vendors to claim a 5% local preference discount on their proposals if they meet the county's definition of a local business or local non-profit organization. San Mateo County defines a "Local Business" as any for-profit entity with its principal place of business or headquarters in San Mateo County, and a "Local Non-Profit" as a tax-exempt 501(c)(3) public charity organization with its principal office or headquarters in San Mateo County. Vendors applying for the local preference must complete the self-attestation form and submit it with their bid or proposal response. The form requires vendors to confirm their principal office or headquarters location in San Mateo County and provide business identification information including organization name, address, contact details, website, and authorized representative signature.
The county reserves sole discretion to determine eligibility for the preference and may request additional documentation to substantiate claims. Vendors must certify under penalty of perjury that all information provided is true and accurate. Any business that falsely claims the local preference is subject to penalties under Chapter 2.89 of the San Mateo County Ordinance Code and will be rendered ineligible for county contract consideration for a minimum of one year from the date the false certification is discovered. This preference mechanism applies to the broader structured cabling solicitation, which includes a two-phase evaluation process with 110 total points distributed across organizational capacity, method and approach, and price criteria, with additional consideration given to local businesses, non-profits, and small or micro businesses as part of the overall evaluation framework.
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Text version
San Mateo County Local Preference Self-Attestation Form
Chapter 2.89 of Title 2 of the San Mateo County Ordinance Code allows a 5% preference on goods and services solicitations submitted by local businesses.
The County of San Mateo defines:
• “Local Business” as any for-profit business which has its principal place of business, or is headquartered, in San Mateo County.
• “Local Non-Profit" as a tax-exempt public charity organization (within the meaning of section 501(c)(3) of the Internal Revenue Code) that is formed for purposes other than making a profit, is exempt from paying federal income taxes on the income generated for their exempt purposes, and has its principal place of business, or is headquartered, in San Mateo County.
If you are applying for the 5% local business preference, please answer the following question:
1. Is your business or non-profit organization principal office located, or headquartered, in San Mateo County?
Yes No Other: _______________________________
The County shall have the sole discretion to determine whether satisfactory proof of eligibility for a preference has been provided. In addition to any other penalties provided by law, any business that falsely claims a preference pursuant to Chapter 2.89 shall be ineligible for consideration for County contracts for a period of not less than one year from the date of discovery of the false certification.
The Local Business Preference Certification form must be completed and submitted with your bid/proposal response if you are applying for the 5% local business preference. Upon request, vendor agrees to provide additional information to substantiate this self-attestation. Vendor certifies information provided is true and accurate under penalty of perjury.
Business or Non-Profit Organization Name
Business or Non-Profit Organization Address (Principal Office/Headquarters) City, State, Zip Code (No P.O. Box)
Website (if available)
Telephone Number
Title of Authorized Representative
Signature of Authorized Representative
Date
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