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(To he completed only by ContractorslBidders chdin ing to be a "local Indiana business "pursuant to L C. 36-1-12-22) <br />INDIANA LOCAL BUSINESS PREFERENCE CLAIM <br />A "local 1`ndiana business " refers to any of thefolloWing: <br />(1) A business whose principalplace of business is located in an affected county. <br />(2)A business thatpays a majority of itspayroll (in dollar volume) to residents of ajfected counties. <br />(3) A business that employs residents of affected counties as a majority of its employees. <br />(4) A business that makes s�gnificant capital investments in the affected counties as defined in rules adopted by thepolitieal <br />subdivision. <br />(5)A business that has a substantial positive economic impact on the affected counties as defined by criteria in rules adopted by <br />the politicaZ subdivision. <br />An "affected county" refers to St. Joseph County, Indiana, or thefollowing counties located adjacent to St. Joseph County <br />Elkhart County, Marshall County, Starke Coun ly and LaPorte County <br />There are thefollowing price preferencesfor supplies purchasedfi-om a local Indiaiia business: <br />• 5Yofor a purchase expected by the purchasing agency to be less than $50, 000 <br />• 3%jor a purchase expected by the purchasing agency to beat least $50, 000 but less than $100, 000. <br />......... . . . -.-. I %for a purchase expected by the purchasing agency to be at least $100, 000, <br />Date: April-23, 2018 <br />Pursuant to I.C� 36-1-12-22, Selking International Trucks - claims a local Indiana business <br />preference for Project 3 1/2T Util-ity Truck (Projectffi L located within the City of <br />South Bend, St. Joseph County, Indiana. <br />93 The location of the principal place of business is 4849 W. Western Ave., South Bend, IN <br />(Address) <br />St. Joseph County, Indiana <br />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 />IN 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 SUPFL YING SUPPOR TING PA YROLL RECORDS, BIDDER SHALL REDACTALL <br />SOCIAL SECURITYNUMBERS. <br />Datedthis 23rd d of Apri.1- 12018 <br />Selking Tnternational <br />Contraac�/Bidder (Firm) <br />SigAature of Contractor/Bidder or Its Agent <br />Kennelb. A ....... Waite, Agent <br />Printed Name and Title <br />