HomeMy WebLinkAboutLocation Affidavit 64.6. OFFICE LOCATION AFFIDAVIT
Please type or print clearly. This Affidavit 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:
ner c4'i6vrron en /de?,
Entity Type: (check one box only) [] Partnership
[] Sole Proprietorship 'Corporation
ra ion Doc. No.;_ Date stablishe Occupatio 1 License o: Date of Issua ce:
47540 2a e) / . /15% 276
Qific� Location ser, . r
PRESENT
Street Address: Q i.a / r %/w44 •Zeg
City: 1 /r State: —t . How long at this location:
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PREVIOUS
Street Address:
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 ]ow bid amount, if the original bid amount submitted by the local vendor is not more than ten percent ()OW 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.
1 (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 fide local bidders/proposers by this section.
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Narn€
Signature ` `
Prin 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 Sworn before me that this is a
Notary Public, State of Florida
t this _ 144INNIZ /
it MY CtR 11S$1ON # DD 510t09
EXPIRES: February 26, 2013
Bagdad 'Mu Naar/ P $o Undeontocs
My Commission expires�
[1 Personally known to me; or
� . [] Produced identification:
Please submit with your bid copies of Occupational License, professional andlor 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 Page 33
Bid No. 05-06-006