Local Business Entity Cert.pdf

APPENDIX D

LOCAL BUSINESS ENTITY OR LOCAL IMPACT CERTIFICATION

Instructions: Applicants who seek as a positive factor in the City’s consideration of their application that they meet the Local Business Entity or Local Impact criteria as provided in Mayoral Executive Order No.

04-12 should complete this Certification and return it with their application. Applicants providing this Certification should also include in a separate section of their application labeled “Local Business Entity or Local Impact Certification,” a statement that the Applicant believes it has met the Local Business Entity or Local Impact criteria “as set forth in the attached Local Business Entity or Local Impact Certification.” Check all appropriate certification options that are applicable to Applicant and sign below:

Applicant Name: _______________________________________________________________________

Local Business Entity Certification

I certify that the Applicant named above is a Local Business Entity because Applicant complies with the following criteria set forth in Section 17-109(3)(b) of the Philadelphia Code:

I. During the preceding 12 months, Applicant has filed a Business Income and Receipts Tax return with the City establishing that Applicant conducted business within the City within the calendar year preceding the filing of the return; and

II. During the preceding 18 months, Applicant:

A. Has continuously maintained a valid Commercial Activity License and all other licenses and permits necessary to conduct business with the City;

B. Has continuously occupied and staffed an office within the City, where business is conducted; and

(1) Applicant’s principal place of business is located in the City; or

(2) Applicant continuously satisfied at least two of the three following requirements (Check those applicable to Applicant):

(a) More than 60% of Applicant's full-time employees are reported as Philadelphia Residents on the City of Philadelphia Annual Reconciliation of Employer Wage Tax;

(b) More than 50% of Applicant’s full-time employees work in the City at least 60% of the time; or

(c) More than 75% of Applicant’s gross receipts are reported on Applicant’s Business and Income Receipt Tax return as Philadelphia receipts.

Local Impact Certification

I certify that in the performance of a contract resulting from this RFP, the Applicant named above will employ City residents.

I certify that in the performance of a contract resulting from this RFP, the Applicant will perform the work in the City.

Authorized Signature Date

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