Opening of Bids - Spec AE Preventative Maintenance on 39 Generators for Various City Depts - Herrman & Goetz Inc

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(To be completed only by Contraclors/Bidders clainting to be a `local Iiidiarra hrrsirless "pur-stia?it to I.C. 36-1-12-22) INDIANA LOCAL BUSINESS PREFERENCE CLAIM A "local Indiana business" refers to any of die_ following.• (1) A business whose principal place of business is located in an affected county. (2) A business that pays a majority of its payr°o11(in dollar volume) 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 dcfined 4)) criteria in rules adopted by the political subdivision. Art "a ffected county " refers to St. Joseph Count), Ir?diana, or the folloit ing counties located adjacent to St. Joseph County: Elkhart Counot Marshall County, Starke County and LaPorte County There are the following price preferences for supplies purchased 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 be at least $50, 000 but less than $100, 000, • 1 %fora purchase expected Uy the prrrcliasing agency lobe at least $I00, 000. Date: November 14,2017 Pursuant to I.C. 36-1-12-22, Herrman & Goetz, Inc. claims a local Indiana business preference for Project .Spec AE—Preventative Maintenace o$Project # ) located within the City of South Bend, St. Joseph County, Indiana. 35 Generators f or Various City Dept. s © The location of the principal place of business is 225 S. Lafayette Blvd., So. Bend, IN (Address) ® St. Joseph County, Indiana ❑ 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 1 4th day of November, 20—L7-- Herrman & Goetz, Inc, Cont der Si nature Con or/Bidder or Its Agent Larry Cripe, Power -of -Attorney Printed Name and Title