Award Bid - Spec P - Two More or Less 2018 or Newer Mid Size Four Door Hybrid Sedan Automobiles - Gates Toyota

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i (To be completed only by Contractors/Bidders chdining to be a "local Indiana bmsiuess"prnsucmtt to I.C. 36-1-12-22) I INDIANA LOCAL BUSINESS PREFERENCE CLAIM A ''local Indiana business "refers to anv of the follow4ng: (])A business avlrose principal place of brts•ines•s is located in crn rrffeetecl c•ourrty. (2) A business that pays cr nrajnrity of its payroll (itr dollar volrvne) to r esirleuts of affected counties, (3) A business that.emplgys residents of afffected corarties as a majority of its employees. (4) A business that stakes significant capital investments in the affected counties as defined in rules adopted by the political subdivision. (5) A business that has a substantial positive ec•ononric impact on the alketed counties as defined by criteria in rules adopted by the political subdivision. An "gjfected county" refers to St. Joseph County, Indiana, or the following counties located adjacent to St. Joseph Count Elkhart County, Morshall County, Starke County and LaPorte County There are the jblloivirrg price preferences Jbr ,supplies purchased from a local Indiana business: • 5% fora purchase evpected by the ptfrchasing crgerrcy to be less than $50,000 • : 3%,far a purchase expected by the purchasing agency to be at least $50,000 but less than $100,000. • 1 % fora purchase expected by the purchasing a encv to beat least $100,000, Date: P� Pursuant to I.C. 36-1-12-22, C,4TES 1`010 TA claims a local Indiana business j preference for Project /kin- St4 G -FoLkk- DOOR At4!V( 1) (Project # SAES- ) located within the City of South Bend, St. Joseph County, Indiana. € � The location of the principal place of business is �� (0 aft i v 0 ��, �' � � � t "i �1) � ta,t�r,•�.,.,t 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 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 SUPPL PING SUPPORTING PAYROLL RECORDS, BIDDER SHALL REDACT ALL SOCIAL SECURITY NUMBERS, Dated this day of�20 1 5 GCS To Contract r der (Finn Signature of Contractor/Bidder or Its Agent SfiffU�1 ()2(+C[C FL C f /qfttV A6f Printed Name and Title is 8