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(To be completed only by Contractors/Bidders claiming to be a 'local Indiana business" pursuant to I.C. 36-1-12-22) <br />INDIANA LOCAL BUSINESS PREFERENCE CLAIM <br />A local Indiana business refers to any t� of the following: <br />(1) A business whose principal place of business is located in an affected county. <br />(2) A business that pays a majority of its payroll (in dollar volume) to residents of affected counties. <br />(3) A business that employs residents of affected counties as a majority of its employees. <br />(4) A business that makes significant capital investments in the affected counties as defined in rules adopted by the <br />political subdivision. <br />(5) A business that has a substantial positive economic impact on the affected counties as defined by criteria in rules <br />adopted by the political subdivision. <br />An "affected county" refers to St. Joseph County, Indiana, or the following counties located adjacent to St. Joseph <br />County: Elkhart County, Marshall County, Starke County and LaPorte County <br />There are the following price preferences for supplies purchased from a local Indiana business: <br />• 5% for a purchase expected by the purchasing agency to be less than $50,000 <br />• 3% for a purchase expected by the purchasing agency to beat least $50,000 but less than $100,000. <br />° � � ,g...� .tl ...s _ ,000. <br />or a pa,ritae pl�er°(aw the urn �r����a �� towbe at least 100 ._. ...._ _.�....._..._ . ...... <br />1/of <br />Date: April 10 2020 <br />Pursuant to I.C. 36-1-12-22, Al,e ap.di.@.r,.Qhpmj j get W t1......_._..._ . claims a local Indiana business <br />-Qfpreference for Project Water,Treetpaent hel ,, z2.Q24..�.,m (Project # )located within the City of <br />South Bend, St. Joseph County, Indiana. <br />FQ The location of the principal place of business is „ 7593 S First Road, Kinr3bury, IN 464 <br />v — ...._.- . (Address) _ — .N......, <br />St. Joseph County, Indiana <br />The following county located adjacent to St. Joseph County, Indiana: wwLAPORTE <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 />❑ The majority of the business's employees for the 12 months prior to the date of this Bid are residents of St. <br />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 amount <br />paid to all employees of the business, and (ii) the total payroll amount paid to employees who are residents <br />of St. Joseph County and the adjacent county noted above. <br />WHEN SUPPLYING SUPPORTING PAYROLL RECORDS, <br />BIDDER SHALL REDACT ALL SOCIAL SECtJ �T NUiI+i13ER, <br />Dated this 10th day of April , 2020. <br />Ae Oder lei.- e �_..01 ution- — <br />Corlti°a` /Bi i r (Firm <br />xlt atr are_µ_ ..... .. _ _ .....---- .-..w----- ....... _... <br />of Contractor/Bidder or Its Agent <br />Robert Davidson President <br />Printed Name and Title <br />