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2010-111 (2)
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2010-111 (2)
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Entry Properties
Last modified
7/2/2018 1:53:33 PM
Creation date
3/23/2016 8:35:47 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Bid
Approved Date
01/13/2010
Control Number
2010-111
Agenda Item Number
12.J.1.
Entity Name
Timothy Rose
Subject
North Water Treatment Plant Raw Water Transmission System
Area
Pre Bid Meeting
Project Number
UCP 2422
Bid Number
201024
Supplemental fields
FilePath
H:\Indian River\Network Files\SL000005\S0001WQ.tif
Meeting Body
Board of County Commissioners
Meeting Type
BCC Regular Meeting
SmeadsoftID
8458
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Local Business Certification Form <br />(1) "Local business" shall mean a business that meets all of the followincriteria: <br />g <br />(a) Has had a staffed and fixed office or distribution point, with a verifiable street address, <br />located within Brevard; Indian River; Martin Okeechobee; Osceola; or St. Lucie County for at <br />least one (1) full calendar year immediately prior to the issuance of the request for competitive <br />bids or request for proposals by the County. Post office boxes shall not be used or considered <br />for the purpose of establishing a physical address; and <br />(b) Has had, for at least 12 months prior to the date of the advertisement for the particular <br />good or service being solicited, a current "Local. Business Tax Receipt" issued by Brevard; <br />Indian River; Martin; 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 <br />Indian River County and not as subcontractor, or any l <br />supplier. ower -tier subcontractor, materialrnan, or <br />1 _Company Name:= t vjbSF' �uyL-i 1i�a A I '- <br />r <br />2. Address.- - 1c Ptv I I --Vi 9� <br />177/ <br />3. If applicable, Contractor License or Competency; Card C) Aja <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: T 7 a -56 4 - h( 00 <br />8.Fax Number 'Iq�- <br />9. 1 hereby certify that, If the contract is awarded, the entity set forth n eo <br />m 1 aw ill be the <br />person or entity in direct privity Of contract with Indian River County and not as subcontractor, or <br />any lower -tier subc ofr materialman, or supplier. <br />Signature: <br />Name and Title:'( sy l 1<6 -se <br />VENDOR PLEASE DONOT 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 />. <br />(Authorized Signature) <br />To receive Local Bid preference, this certification andcopies of all required documents must be <br />submitted with your Bid package. <br />00200-3 <br />
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