HomeMy WebLinkAboutLocation Affidavit 24.6. OFFICE LOCATION AFFIDAVIT
NOT APPLICABLE
Please type or print clearly. Thts,Aftidavit must be completed In full, signed and notarized ONLY if your office is located within the
corporate limits of the City of Miami.
Legal Name of Firm: Entity Type: (check one box only) [] Partnership
[] Sole Proprietorship [] Corporation
Corporation Doc, No: Date Established:
Occupational License No: Date of Issuance:
PRESENT
Street Address:
°Mee Loeatiop of the bidder/proposer:
City:
State: How long at this location:
PREVIOUS
Street Address:
City:
State How long at this location;
According to Ordinance No. 12271 (Section 18-85):
The City Commission may other to a responsible and responsive local bidder, who maintains a Local Office, the opportunity of accepting a bid at
the low bid amount, if the original bid amount submitted by the local vendor js not more than ten percent f 10%1 in exces, of the lowest other
responsible and responsive bidder,
The intention of this section is to benefit local bona tide bidders/proposers 10 promote economic development within the corporate limits
of the City of Miami,
(we) certify, under penalty of perjury, that the office location of our firm has not been established with the sole purpose of obtaining the
advantage granted bona Side local bidders/proposers by this section.
Authorize Signature
Print Name
Title
Authorize 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 sole proprietorship or all
partners of a joint venture.)
STATE OF FLORIDA, COUNTY OF DADE
Subscribed and Swornbefore me that this is a true statement this day of 199 [� pknown o me; or
[� Produced identification:
Notary Public, State of Florida My Commission expires
Printed name of Notary Public
Please submit with your bid copies of Occupational License, professional and/or trade License to verify local status. , E e City of Miami
also reserves the right to request a copy of the corporate charter, corporate Income tai flung return and any other documents(s) to verify
the location of the firm's office.
City of Miami
Bid No, 05.06.008
Page 33