HomeMy WebLinkAboutLocation Affidavit 34.6. OFFICE LOCATION AFFIDAVIT
Please type or print clearly. This Affidavit must be completed in dill, 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) fl Partnership
(] Sole Proprietorship [] Corporation
Corporation Doc. No: Date Established:
Occupational License No: Date of Issuance:
Office Location of the bidder/proposer;
PRESENT
Street Address: 1 '�
City: b2 g
PREVIOUS
Street Address:
5 - —, FCOI s
How long at this location;
R.
City:
State How long at this location:
According to Ordinance No. 12271 (Section 18-85):
The City Commission may offer 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. tlm ten percent (10°%) in excess of the lowest other
responsible and responsive bidder.
The intention of this section is to benefit local bona fide bidders/proposers to promote economic development within the corporate limits
of the City of Miami.
i (we) certitj+, under penalty of perjury, that the office location of our fine has not been established with the sole purpose of obtaining the
advantage granted bona fide local bidders/proposers by this section.
Au o i_ ;' •/ 1�—
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
/ po& [1 Personally known to me; or
Subscribed and �• before me that this is a true statement this ��day of Mitj - 1f11�r'". [] Produced identification:
tary ' ublic, State of Florida
Oz tam T
Printed name of Notary Public
My C6ramlegfssiofi expires
Edward D. Elliott
• • = Commission 4DD244663
▪ e• e: Expires: Oct 11, 2007
▪ of FLo Bonded Thru
At3antic Bonding Co., Inc.
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.
City of Miami
Bld No. 06-06-006
Page 33