Form_4_Local_Vendor_Preference_Certification.pdf
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- Attached to
- Utility Enterprise Asset Management Consulting
- Solicitation number
- 26-8642
- Issued by
- Collier County, Florida
About this file
This is a Local Vendor Preference Certification form issued by Collier County, Florida's Procurement Services Division for use in response to the Utility Enterprise Asset Management Consulting Invitation for Qualifications. The form permits vendors to certify their status as local businesses eligible for preference consideration under Section Sixteen of the Collier County Procurement Ordinance. Vendors must affirm they maintain a physical business address within Collier County limits from which staff operates, and they must demonstrate verifiable and measurable contributions to the county's economic development and well-being through employment retention and expansion, tax base support, or employee residency. Certification requires submission at the time of bid or proposal submission, and vendors must possess a current Local Business Tax Receipt issued by the Collier County Tax Collector prior to submission. The form requests the vendor's company name, date of certification, authorized representative signature, and title.
Misrepresentation of local preference status results in loss of local preference eligibility for up to one year. The County reserves the right to request supporting documentation substantiating the information provided on the certification, and failure to provide such documentation renders the vendor's submission non-responsive. All certifications are made under penalty of perjury by a duly authorized corporate representative with signature authority. This certification applies to the Utility Enterprise Asset Management Consulting opportunity, which involves professional consulting services for projects with a value up to $500,000 per fiscal year, with any individual work assignment exceeding that threshold requiring Board of County Commissioners approval.
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Text version
Version 2 9.2.25
Procurement Services Division
Form 4: Local Vendor Preference Certification
(Check Appropriate Boxes Below)
State of Florida (Select County if Vendor is described as a Local Business) Collier County Lee County
Vendor affirms that it is a local business as defined by Section Sixteen of the Collier County Procurement Ordinance:
• A physical business address in Collier County with a County business address as listed with the Florida Department of State, Division of Corporations located within the limits of Collier County from which the vendor's staff operates and performs business in an area zoned for the conduct of such business. A post office box or a facility that receives mail, or a non-permanent structure such as a construction trailer, storage shed, or other non-permanent structure shall not be used to establish the physical address. In addition to the foregoing, a vendor shall not be considered a "local business" unless it contributes to the economic development and well-being of Collier County in a verifiable and measurable way. This may include, but not be limited to, the retention and expansion of employment opportunities, support and increase to the County's tax base, and residency of employees and principals of the business within Collier County. Vendors shall affirm in writing their compliance with the foregoing at the time of submitting their bid or proposal to be eligible for consideration as a "local business" under this section. A vendor who misrepresents the Local Preference status of its firm in a proposal or bid submitted to the County will lose the privilege to claim Local Preference status for a period of up to one year; and
• A current local Business Tax Receipt (also known as an Occupational License) issued by the Collier County Tax Collector prior to bid or proposal submission.
If requested by the County, Vendor will be required to provide documentation substantiating the information given in this certification. Failure to do so will result in the vendor’s submission being deemed non-responsive.
Under penalties of perjury, I certify that the information shown on this form is correct to my knowledge and a duly corporate authorized representative with signature authority.
Company Name: _________________________________________
Date: _____________________________
Signature: ____________________________________________ Title: _____________________________
| Collier County: Off |
| Lee County: Off |
| Company Name_4: |
| Date22_af_date: |
| Title_4: |
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