HomeMy WebLinkAboutexhibit5City of Miami
PRIMARY OFFICE LOCATION
Affidavit
Please type or print clearly. This Affidavit must be completed In full, signed and notarized for local preference consiitsrmtic ri 1
Legal Name of Firm:
erg,'t(on mex41).1 Pre CnrrnL.nr.Q
Corporation Doc, No:
cc
0
Date Established:Jitriq
• Primary Offce Location (Principal establishrnerlt.131 the bidder/proposer):
rEntity Type:'aver ova cos r D Fiartnersnip
O Sole Propnetorsflip ZGOrOcranon
g5 The .
Oceupattonal License No:
Street Address:
170 o N r u) 5c th o er
City:
Street Address:
10502 fJ .+)• 13' s--.
City.
-1 ia14 , Carchens
Scats:
Ft
State:
FL
Date of Issuance:
How long at bit location:
�lg.i
How long at It'IS IOCanon:
?)1/2. \/ ar
According to the City of Miami's Charter 29-A as amended:
'All contracts..,shall be awarded by but commission to the lowest responsible bidder.... provided, however, that ri the amount of a bid Or proposal
submitted by a vendor whose primary office is located in the City of Miami is not more than...10% in excess of the lowest outer responsible bidder or.
proposer, such local vendor may be awarded the contract...'
The intention of this section is to benefit local bona fide vendors/proposers to promote economic dev
i (wej certify,- under penalty of perjury. that Vie primary office locibort of our firm has not been established
advantage granted bona fide local vendors/proposers by this Becton.
opme \withi
e Signature
arihf2 �� P� , POLL
the City of Miami.
se of obtaining the
Auihonzs Sgnature
kip,isr,'t n Pre a
Pnnt frame
Se.rrf\-ary
Tula
(Must be signed by the corporate secretary of a Corporation or one general partner of a partnership or the propnetor of a sole bropnetorShip or all
partners of a joint venture.)
STATE OF FLORIDA. COUNTY OF DADE `` lB Personalty known to me: or
Subscribed and Sworn before me mat this is a true statement this 1 .day of 200f ❑ Produced identitiCanon:
ivy
Notary Public, State of Florida
Mar i avv '
Printed Name of Notary Public
o 1 10 lo%
My Commission Expires
I,arrrr, MARIATRIANA
r yVIOr4i MY COi M' :SION 0 DD 360703
� srn°a EXT.:H : October 8, 2000
1.0oo. NOTARY L. Notary DI count noon. Co.
Pleas* submit with your bid, cootie, of occupational License. professional and/or trade License to verily local status. The City of Miami,
also reserves the right to request a copy of the corporate charter. corporate income tea filing return and any other documerl(s) to verify
the location of the firm's primary office.