HomeMy WebLinkAboutLocation Affidavit 34.6. 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
corporatelimits of the City of Miami.
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J....1� n t,t)� ram' �]�n �C � 6,im ( .
Legal Name of Firm: Entity Type: (check one box only) [] Partnership
[] Sole Proprietorship ficsuporation
Corporation Doc. No:
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PRESENT
Street Address: ! D i 5 S- S/Lci
Date.Estaslished:
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Occupational License No: Date of issuance:
5 (1 ? v 1 1 .-? (0 5�
City: 1 ?tote:
1 rvn -r1 ?late:
PREVIOUS
Street Address:
How long at this location:
tiQpie S
City:
State
How long at this location:
According to Ordinance No. 12271 (Section I8-85):
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 bidder.
The intention of this section is to benefit local bona tide 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 e � ith the sole purpose of obtaining the advantage
granted bona fide local bidders/proposers by this section.
1 I Aut
stout t )c.e
Print Name
0w�e r
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 [�p f. [] Personally known tome; or
Subscribed and Sworn before me tl�l this is a trueytatement this /day of /k QiC - " 149` [] Produced identification:
Grs 232-scs
Notary Public, State of Florida
Printed name of Notary Public
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yi Expires: dun 24, 2007
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Please submit with your bid copies of Occupational License, professional and/or trade License to veriftbl: �e5rnenk93Ct bf 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 frm's office.
My ommis ion expires
City of Miami Page 52
Bid No. 04-05-116