Form_4_Local_Vendor_Preference_Certification.pdf
PDF 155 KB Posted
- Solicitation number
- 26-8679
- 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 state and local contract opportunities. The form is designed to allow vendors to certify their status as local businesses eligible for preference consideration in Collier County procurement processes, specifically for the Port of the Islands Property Development or Disposition Invitation to Negotiate issued by the Housing Policy & Economic Development Division. Vendors must demonstrate compliance with Section Sixteen of the Collier County Procurement Ordinance by certifying they maintain a physical business address within Collier County (excluding post office boxes, mail facilities, or temporary structures), contribute to the county's economic development in measurable ways through employment retention and expansion, tax base support, and employee residency, and possess a current local Business Tax Receipt issued by the Collier County Tax Collector prior to bid submission.
Vendors submitting this certification affirm under penalty of perjury that all information is accurate and are required to provide supporting documentation upon county request, with failure to do so resulting in a non-responsive designation. Misrepresentation of local preference status carries penalties including loss of local preference eligibility for up to one year. The certification form requires submission by a duly authorized corporate representative with signature authority and must be completed at the time of bid or proposal submission to qualify for local business consideration under the county's procurement ordinance.
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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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