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(To be completed only by Contractorsl8kiders claiming to be a "local Indiana business" pursuant to I.C. 36-1-12-22) <br />INDIANA LOCAL BUSINESS PREFERENCE CLAW <br />A "local Indiana business" refers to any 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 or 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 an 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 bees than $50,000 <br />- 3% for a purchase expected by the purchasing agency to beat least $50,000 but less than $100,000. <br />fora purchase expected by the purchqspV aqenqX to beat least $100 ,000. <br />Pursuant to I.C. 36-1-12-22, <br />preference for Project <br />South Bend, St. Joseph County, Indiana. <br />claims a local Indiana business <br />(Project # located within the City of <br />0 The location of the principal place of business Is <br />(Adft-) <br />• St. Joseph County,, Indiana <br />• The following county located adjacent to St. Joseph County, Indiana: <br />• The majority of the business'si 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 (1) the total payroll amount <br />paid to all employees of the business, and (H) the total payroll amount paid to employees who are residents <br />of St. Joseph County and the adjacent county noted above. <br />WHEN SUPPLYING SUPPOR77NG PAYROLL RECORDS, <br />BIDDER SHALL REDACT ALL SOCIAL SECURITY NUMBERS, <br />Dated this day of <br />Contractori5idder (Firm) <br />Mot <br />Printed Name and Title <br />