HomeMy WebLinkAboutOffice Location00510. OFFICE LOCATION AFFIDAVIT (Page 1 of 2)
Please type or print clearly. This Affidavit must be completed in full, signed and notarized ONLY
IF YOU MAINTAIN AN OFFICE WITHIN THE CORPORATE LIMITS OF THE CITY OF MIAMI.
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Legal Name of Firm:
Entity Type: (Check One) Partnership Sole Proprietorship Corporation
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Corporation Document No:
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Occupational License No:
Date Established
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Date o Issuance
Office Location (Establishment of the bidder/proposer):
PRESENT
Street Address: 2 S S S 5 C. Sk
City: RR State:
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How long at this location:
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PREVIOUS
Street Address:
City:
State How long at this location:
According to Section 18-85 of the City of Miami Code, as amended:
The "City Commission may offer to a responsible and responsive local bidder, who maintains an office in
the City of Miami, the opportunity of accepting a bid at the low bid amount, if the original bid amount
submitted by the local bidder does not exceed 110 percent 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.
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00510. OFFICE LOCATION AFFIDAVIT (Page 2 of 2)
Authorize Signature
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Authorized Signature
Print Name Print Name
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Title P Title
Authorized Signature Authorized Signature
(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.)
NOTARIZATION
STATE OF FLORIDA, COUNTY OF MIAMI-DADE
That: Q.C\p. darn/4 personally appeared before me
and acknowledged the foregoing instrument as his/her act and deed.
That he/she has produced po ssoncaUt rnv3n mR.
NOTARY PUBLIC: ,
���`r•"•��= Elisa Hernandez
ix: ) :COMMISSION#DD753535
4.-i4a= EXPIRES: FEB. 10, 2012
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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.
My Commission Expires:
as identification.
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Rid No. 07-08-008 Page 37