Opening of Bids - Spec E - Thirty Nine (39) More or Less 2017 or Newer All Wheel Drive Police Patrol Vehicles - Bloomington's Community Ford-Lincoln, Inc. (no bid bond or security check)

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(To be completed only by Contraetors/Bldders claiming to be a `local Indiana business "pursuant to LC. 36-1-12-22) INDIANA LOCAL BUSINESS PREFERENCE CLAIM A "local Indiana business " refers to any of the following., (1),4 business whose principal place of business is located in an affected county, (2) A business that pays a majority of its payroll (in dollar vohrme) to residents of affected counties. (3) A business that employs residents of affected counties as a majority of its employees. (4) A business that makes significant capital investments in the affected counties as defined in rules adopted by the political subdivision. (5) A business that has a substantial positive economic impact on the affected counties as defined by criteria in rides adopted by the political subdivision. An "affected county" refers to St, Joseph County, Indiana, or the following counties located adjacent to St. Joseph County: Elkhart County, Marshall Coumty, Starke County and LaPorte County There are the following price preferences for supplies pro•chased from a local Indiana business: • 5% for a purchase expected by the purchasing agency to be less than $50, 000 • 3% for a purchase expected by the purchasing agency to beat least $50, 000 bill less than $100, 000. • 1 % for a purchase expected by the purchasing agency lobe of least $100, 000, Date: 51'2212017 Pursuant to I.C. 36-1-12-22, No Local Preference Claimed preference for Project Spec E, 39 +1- 2017 Police Cars South Bend, St. Joseph County, Indiana. claims a local Indiana business (Project # ) located within the City of ❑ The location of the principal place of business is Bloomngton, IN (Address) W/A St. Joseph County, Indiana CNVA The following county located adjacent to St. Joseph County, Indiana: ❑ The majority of the business's payroll for the 12 months prior to the date of this Bid is to residents of St. Joseph County, Indiana or the adjacent county noted above. ❑ The majority of the business's employees for the 12 months prior to the date of this Bid are residents of St. Joseph County, Indiana, or the adjacent county noted above. If the business is deemed to be the apparent lowest, responsible, responsive bidder, then it shall provide supporting documentation for the 12 month period prior to the date of the Bid of (i) the total payroll amount paid to all employees of the business, and (ii) the total payroll amount paid to employees who are residents of St. Joseph County and the adjacent county noted above. WHEN SUPPLYING SUPPORTING PAYROLL RECORDS, BIDDER SHALL REDACT ALL SOCIAL SECURITY NUMBERS. Dated this 22nd day of May 20 17 1nnrn1ncAnn'sz Community Ford, Contractor/Bidder (Firm) Signature of Contractor/Bidder or Its Agent INDIANA Government Sales Manager Printed Name and Title