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Section 00460 <br /> Local Business Certification Form <br /> To receive Local Bid preference, this certification and copies of all required documents must <br /> be <br /> submitted with your Bid package. <br /> " Local business " shall mean a business that meets all of the following criteria : <br /> (a ) Has had a staffed and fixed office or distribution point, with a verifiable street address , located <br /> within Brevard , Indian River, Martin , Okeechobee , Osceola , or St. Lucie County for at least one ( 1 ) full <br /> calendar year immediately prior to the issuance of the request for competitive bids or request for <br /> proposals by the County . Post office boxes shall not be used or considered for the purpose <br /> of <br /> establishing a physical address ; and <br /> ( b ) Has had , for at least 12 months prior to the date of the advertisement for the particular good or <br /> service being solicited , a current " Local Business Tax Receipt" issued by Brevard , Indian River, Martin , <br /> Okeechobee, Osceola , or St. Lucie County, if applicable ; and <br /> ( c) Holds any license or competency card required by Indian River County, if applicable ; and <br /> (d ) If the contract is awarded , will be the person or entity in direct privity of contract with Indian <br /> River County and not as subcontractor, or any lower-tier subcontractor, materialman , or supplier. <br /> 1 . Company Name : K:e450 � r <br /> 2 . Address : n20 <br /> 3 . If applicable , Contractor License or Competency Card # : C G-C (D -] <br /> 4. PLEASE ATTACH COPY OF CONTRACTOR LICENSE OR COMPETENCY CARD <br /> 5 . If applicable , Business Tax Receipt #: Ip <br /> 6 . PLEASE ATTACH COPY OF BUSINESS TAX RECEIPT �� <br /> 7 . Phone Number: 7 7a �p29 y g . Fax Number: 77 <br /> 9 . 1 hereby certify that, if the contract is awarded , the entity set forth in item 1 above will be the person <br /> or entity in direct privity of contract with Indian River County and not as subcontractor, or any lower-tier <br /> subcontractor, materialman , or supplier. <br /> Signatu <br /> Name and Title : AetkbE N r <br /> VENDOR PLEASE DO NOT COMPLETE BELOW <br /> To be completed by an authorized representative from Indian River County Purchasing Division : <br /> Meets definition of Local Business _ YES _ NO <br /> If NO , provide reason : <br /> (Authorized Signature) Date : <br /> 00460-1 <br /> FAEngineering\Capital Projects\0107-53rd St, 58th Ave-US #1 \Contract Documents\00460 - Local Business Certification Form revised 08-20- <br /> 10 .doc <br />