HomeMy WebLinkAboutOffice Location 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 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:
,e`. 'Off ci Ioeatit3n of the lidderipol2osei
PRESENT
Street Address:
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 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 te_p 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) 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,
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 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 fire m's office.
City of Miami Page 30
Bid No. 06-08-098
4.7. STATEMENT OF NO BID
NOTE: If you do not intend to submit a bid on this commodity or service, please return this form in the bid
envelope on or before bid opening. Failure to submit a response after three (3) times without a sufficient
justification of "No Bid" will be cause for removal from the vendor/bidder's list.
Office of the City Clerk
3500 Pan American Drive
Miami, FL 33131-5504
We, the undersigned, have declined to submit a bid on your Bid No. 05-06-098 for RECYCLING BINS for the
following reasons:
Specifications too "tight", i.e., geared toward one brand or manufacturer only (explain below).
Insufficient time to respond to the Invitation for Bids
We do not offer this product or service.
Our schedule would not permit us to perform.
We are unable to meet specifications.
We are unable to meet bond requirements.
Specifications are unclear (explain below).
We are unable to meet insurance requirements.
Remove us from your bidders' fist for this commodity or service.
Other (specify below).
Remarks:
We understand that if this statement is not completed and returned, our company may be deleted from the City of
Miami bidders' list for this commodity or service.
Company Name:
Signature:
Title:
- Telephone:
Date:
A completed vendor application should be returned with this form if vendor has not previously submitted an
application and secured a vendor number from the City.
City of Miami Page 31
Bid No. 05-06-09B
5.0 BID RESPONSE CHECK LIST
This checklist is provided to help you conform to ail requirements stipulated in this IFB.
1. Bid Certification Form (Form 4.1.)
This form must be completed and signed to validate your bid
2. Bid Form- (Form 4.2.)
This form must be completed and signed by bidder
3. Bidder Qualification Statement (Form 4.3.)
This form should be completed in its entirety to verify the capability of
bidder to perform/deliver the services/goods specified in the IFB
4. Minority/Women Business Affairs Registration Affidavit, if
applicable (Form 4.4.)
Must be completed only if one or more of the owners in the business
enterprise is at least 51% owned by a Black, Hispanic or Female.
5. Affirmative Action Policy for Equal Employment Opportunity
(Form 4.5.)
Should be completed by Bidder.
B. Office Location Affidavit, if applicable (Form 4.6.)
Section 18-85 of City Ordinance No. 12271, states that the City
Commission may offer to a responsible and responsive 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, (Must be signed and notarized by
the local bidder, only for use in attesting office location). The City
reserves the right to verify local status.
7. Statement of No Bid, only If applicable (Form 4.7.)
If you do not intend to submit a bid on this commodity or service,
please return this form in the bid envelope on or before bid opening. 1f
the "Statement of No Bid" form is not completed and returned, your
company may be deleted from the City of Miami bidder's list for this
commodity or service.
B. • Factory Information sheets (specifications, brochures)
• Test results of Items bid
• Manufacturer's installation Instructions
• Product warranty
• Show Drawings
Required to be
Submitted with
Bid
Yes ® No ❑
Yes ® No ❑
Yes ® No ❑
Yes ® No El
Yes ® No ❑
Yes ®No❑
Yes ® No ❑
Yes ® No ❑
TO BE SUBMITTED AS PART OF YOUR BID RESPONSE.
City of Miami Page 32
Bid No. 05-06.098