HomeMy WebLinkAboutaffidavitCity of Miami, Florida
6.4. LOCAL OFFICE LOCATION AFFIDAVIT
RFQ #02-03-163
Please type or print clearly. This Affidavit must be completed In full, signed and notarized QNt.y If your office is located
within the corporate limits of the City of Miami.
Legal Name of Firm:
Partnership
Corporation
Entity Type: (check one box only) []
[] Sole Proprietorship (]
Corporation Doc. No:
Date of issuance:
Date Established:
Occupational License No:
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PRESENT
Street Address:
City:
State:
How long at this location:
PREVIOUS
Street Address:
City:
State
How long at this location:
The Intention of this section is to benefit local bona fide bidders/proposers to promote economic development within tho
corporate limits of the City of Miami.
I (we) certify, under penalty of perjury, that the office location of our firm has not been established with the sole purpose of obtainincl
the advantage granted bona fide local bidders/proposers by this section.
(Corporate Sea[)
Authorized Signature
Print Name
Title
Authorized Signature
Print Name
Title
(Must be signed by the corporate secretary of a Corporation or one general partner of a partnership or the proprietor of a solo
proprietorship or all partners of a joint venture.)
STATE OF FLORIDA, COUNTY OF MIAMI-DADE
p Personally known to me; or
Subscribed and Sworn before me that this Is a true statement this day of 200_ __ I] Produced
identification:
Notary Public, State of Florida My Commission expires
Printed name of Notary Public
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(Seal)
City of Miami, Florida RFQ #02-03-163
Please submit with your bid copies of Occupational License, professional and/or trade License to verify local status. The
City of Miami also reserves the right to request a copy of the corporate charter, corporate income tax filing return and any
other documents{s) to verify the location of the firm's office location.
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