Laserfiche WebLink
Section 00320 <br />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 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 River <br />County and not as subcontractor, or any lower -tier subcontractor, materialman, or supplier. <br />1. Company Name: <br />2. Address.- <br />3. <br />ddress: <br />3. If applicable, Contractor License or Competency Card #: <br />4. PLEASE ATTACH COPY OF CONTRACTOR LICENSE OR COMPETENCY CARD <br />5. If applicable, Business Tax Receipt #: <br />6. PLEASE ATTACH COPY OF BUSINESS TAX RECEIPT <br />7.Phone Number: 8.Fax Number: <br />9. 1 hereby certify that, If the contract is awarded, the entity set forth in item 1 above will be the person or <br />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: <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) <br />Date: <br />To receive Local Bid preference, this certification and copies of all required documents must be submitted <br />with your Bid package. <br />00320-1 <br />