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(To be conipletedon1jP by ContractorslBidders clahning to be a "local Indiana business "pursuant to I.0 36-1-12-22) <br />INDIANA LOCAL BUSINESS PREFERENCE CLAIM <br />A "local Indiana bits iness " refers to any of thefollowing: <br />(1) A business i4,hose principal place of business is located in an affected counry. <br />(2) A business thatpto�s a tnqjorio� of its payroll (in dollar volutne) to residents of affected counties. <br />(3) A business that einploys residents of affected counties as a inajority of its einployees. <br />(4) A business that inakes significant capital investments in the affected counties as defined in rules adopted by the political <br />subdivision. <br />(5) A business that has a substantial positive econoinic impact on the affected counties as defined by criteria in rules adopted by <br />the political subdivision. <br />An "affected county" refers to St. Joseph County, Indiana, or thefollowing counties located adjacent to St. Joseph County: <br />Elkhart County, Marshall Couni)� Starke County and LaPorte Counly <br />There are thefollowing price preferences,for supplies purchasedfiroin a local Indiana business: <br />* 5%for a purchase expected by the purchasing agency to be less than $50, 000 <br />* 3%for apurchase expected by the purchasing agency to beat least $50, 000 but less than $100 000, <br />* I%Jor apurchasee, <br />�peeled by thepurchasing agency to be at least $100,000. <br />Date: APRIL 24, 2018 <br />Pursuant to I.C. 36-1-12-22, JORDAN FORD <br />preference for Project FULL SIZE CARGO VANS (Project 4 <br />South Bend, St. Joseph County, Indiana. <br />claims a local Indiana business <br />Sp C C ) located within the City of <br />The location of the principal place of business is 609 E JEFFERSON, MISHAWAKA, IN 46545; <br />(4dflress) <br />St. Joseph County, Indiana <br />F-1 The following county located adjacent to St. Joseph County, Indiana: <br />The majority of the business's payroll for the 12 months prior to the date of this Bid is to residents of St. <br />Joseph County, Indiana or the adjacent county noted above. <br />[X1 The majority of the business's employees for the 12 months prior to the date of this Bid are residents of <br />St. Joseph County, Indiana, or the adjacent county noted above. <br />If the business is deemed to be the apparent lowest, responsible, responsive bidder, then it shall provide <br />supporting documentation for the 12 month period prior to the date of the Bid of (i) the total payroll <br />amount paid to all employees of the business, and (ii) the total payroll amount paid to employees who are <br />residents of St. Joseph County and the adjacent county noted above. <br />WHEN SUPPL YING SUPPOR TING PA YROLL RECORDS, BIDDER SHALL REDA CTALL <br />SOCIAL SECURITYNUMBERS <br />Dated this -24TH d of APRIL 20 18 <br />JORDAN FORD <br />Contractor/Bidder (Firm) <br />46i-Ac A W-,( a I eu�-- <br />S' nature of Contractor/Bidder or Its Agent <br />ABRA STARKWEATHER <br />D <br />COMMERCIAL FLEET SALES MANAGER <br />Printed Name and Title <br />