Opening of Bids - Janitorial-Cleaning Supplies 2017 Spec S - Sanco Distributing, Inc.

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(To be completed only by CoutractorsBidders clahning to be a "locallurliana business"pursuant to I.C. 36-1-12-22) INDIANA LOCAL BUSINESS PREFERENCE CLAIM A "local Indiana business" refers to any o/'the following: (1) A business whose principal place of business is located in an affected county, (2) A business that pays a majority cif its payroll (in dollar volume) to residents of affected counties. (3) A business that employs residents of affected counties as a tnajorio, of its employees. (4) A business that makes significant capital hwestrnents in the affected counties as defined in rules adopted by the political subdivision. (5) A business that has a substantial positive econotnic impact on the affected counties as defined by criteria in rules adopted by the political subdivision. An "af fecled county " refers to St. Joseph County, Indiana, or the follrnving counties located adjacent to St. Joseph County: Elkhart Corm> ,, Marshall County, Starke County and LaPorte Counq 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 (it least $50,000 Ind less than $100,000, • 1 % or a purchase e, ected b , the pm•chasitt a enc , to be at least $100, 000. Date: 06-26-17 Pursuant to I.C. 36-1-12-22, preference for Project South Bend, St. Joseph County, Indiana. claims a local Indiana business (Project # ) located within the City of 919 N. OLIVE ST. © The location of the principal place of business is (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 docurnentation for the 12 month period prior to the date of the Bid of (i) the total payroll arnount 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. WHENSUPPLYING SUPPORTING PAYROLL RECORDS, BIDDER SHALL REDACT ALL SOCIAL SECURITY NUMBERS. Dated this day of 120 Contractor/Bidder (Firm) Signature of Contractor/Bidder or Its Agent Printed Name and Title M.