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Local Business Certification Form <br /> ( 1 ) " 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 : Synagro South LLC <br /> 2 . Address : 2200 N Kings Highway Ft Pierce FL 34951 <br /> 3 . If applicable , Contractor License or Competency Card # : none to our knowledge <br /> 4 . PLEASE ATTACH COPY OF CONTRACTOR LICENSE OR COMPETENCY CARD <br /> 5 . If applicable , Business Tax Receipt # : n / a <br /> 6 . PLEASE ATTACH COPY OF BUSINESS TAX RECEIPT <br /> 7 . Phone Number : ( 772 ) 461 -0233 <br /> 8 . Fax Number: ( 772 ) 461 - 0234 <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 /> Signature : <br /> Name and Title : Karl J . Scott , Vice President _ & Assistant Secretary <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 /> Date : <br /> (Authorized Signature) <br /> To receive Local Bid preference , this certification and copies of all required documents must <br /> be <br /> submitted with your Bid package . <br /> Page 23 of 47 <br />