HomeMy WebLinkAboutLocation Affidavit4.6.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 r,f Miami.
Legal Name of Firm: epl-ty r,SL i.EO S irs. Cirfvrpvvi1.,
A fleAV CnYF►lattiavl
Entity Type: (check one box only [] Partnership
[] Sole Proprietorship Corporation
Corporation Doc. No:
SoIID
PRESENT
Street Address:
Date Established:
IS I-i
Occupational License No: Da
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e of Issuance:
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City:
Mit mi.
State:
33176
PREVIOUS
Street Address: IC/�e'tI
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City:
1_41,14 41,• dale 1.0. Y es
State
Ft_ 233/ 3
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 is not more than ten percent (10%) in excess of the lowest other
responsible and responsive binder.
How long at this location:
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How long at this location:
as year-f
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 bon fide 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
[] Personally known to me; or
Subscribed and Sworn before me that this is a true statement this day of 199 . [] Produced identification:
Notary Public, State of Florida My Commission expires
Printed name of Notary Public
Please submit with your hid conks 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 Page 41
Bid No. 04-05-104
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