HomeMy WebLinkAboutPR 15452: APPLICATION FOR CERTIFICATION AS A LOCAL BUSINESS ENTERPRISE (LBE)Memorandum
City of Port Arthur, Texas
To: Steve Fitzgibbons, City Manager 4~,
From: Rebecca Underhill, Assistant City a~ec
Date: August 18, 2009
Subject: Proposed Resolution 15452
The application for LBE certification is ready for distribution. The application will be posted on the City's
website, and publicized on the government channel, through the Chamber of Commerce, and through other
available media in order to encourage participation.
P. R. NO. 15452
JJA: 08/18/09
RESOLUTION NO.
A RESOLUTION AUTHORIZING THE DISTRIBUTION
AND COLLECTION OF THE CITY OF PORT ARTHUR
APPLICATION FOR CERTIFICATION AS A LOCAL
BUSINESS ENTERPRISE (LBE)
WHEREAS, the City of Port Arthur has various industrial district agreements which encourage
industry to support the community by purchasing goods and services from `Local Business Enterprises'
(LBE); and
WHEREAS, the City Council has engaged Dr. Janis Hutchins to develop a methodology whereby
to identify LBEs and monitor industry's utilization of them; and
WHEREAS, Dr. Hutchins has prepared the application for LBE certification, attached hereto as
Exhibit "A".
NOW THEREFORE BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
PORT ARTHUR:
Section 1: The facts and opinions in the preamble aze true and correct.
Section 2: The City Council hereby authorizes Dr. Hutchins to proceed with the distribution of
the application as presented.
READ, ADOPTED, AND APPROVED, this day of September, 2009 AD, at a Regular
Meeting of the City Council of the City of Port Arthur, Texas by the following vote:
AYES: Mayor:
Councilmembers:
NOES:
Mayor
ATTEST:
Terri Hanks, City Secretary
APPROVED AS TO FORM:
~ ~~~~
Mark Sokolov, City Attorney
APPROVED FOR ADMINISTRATION:
Steve Fitzgibbons, City Manager
k~~~~~Zc,~--~
Rebecca Underhill, Assistant City Manager
Z:fivance//enni(er/ResoWtions/LBB /Dr. Hutchins
City of Port Arthur Application for
q~I~ CERTIFICATION AS A LOCAL BUSINESS ENTERPRISE (LBE)
Mail to: Ms. Rebecca Underhill, Assistant Ciry Manager, City oC Part Arthur, P.O-Box 1089, Port Arthur, TX 77641-1089
The purpose of this program is to promote spending by companies that have industrial district agreements with qualified Port
Arthur L8E's and to increase the diversity of Port Arthur businesses with which such companies procure goods and services so that
the pool of such businesses is representative of the business community at forge.
1. Federal Employer's Identification number (EIN) (Do notenreryour5ocial5ecuriry NumberJ:
Provide the 9-digit federal EIN assigned to you for the purpose of filing your businesi federal income tax returns with the
Internal Revenue Service (IRS). If you do not have a federal EIN, one may he obtained free of charge from the IRS on-line at
htto://www.irs.eov/businesses/ Or by calling the IRS at (800)-829933.
z. Business Structure -Check the appropriate box that identifies your business structure.
^ -Sole Proprietorship ^ -Corporation ^ -Limited (Liability) Partnership
^ -Partnership ^ -Joint Venture ^ -limited (Liability) Company
3. Business Name, Mailing Address and Physical Address -Include physical address if different from moiling address
Business Name:
Mailing Address:
City:
Physical Address:
City:
Contact's Name:
State: TX ZIP: County:
State: TX ZIP: County:
Mobile Phone Number:
a. Internet Web Page/URL Address (if applicobleJ
s. E-Mail Address (if applicable)
6. Business Phone ft:
7. Employees - - Full-time Part-time
(Port Arthur Site)
Business Fax #:
Full-time
Part-time
(All Sites, Including Port Arthur)
s. Payroll -Wages paid for previous calendar year $ (Full- and Part-time) 5 (Full- and Part-time)
(Port Arthur Site) (All Sites, Including Port Arthur)
9. Check all that apply:
Minority/WOmen Owned Business (MWBE) Historically Underutilized Business (HUB) Disadvantaged Business (DBE)
^ -Yes ^ - No ^ -Yes ^ - No ^ -Yes ^ - No
10. Is your company a member of the Greater Port Arthur Chamber of Commerce? ^ -Yes ^ - No
11. Business Category Description -Check the boxes that best identify the services provided by your business.
^ (Ol{ -Heavy Construction other than Building Construction ^ (06) -Other Services including legal Services
0(02)-Building Construction, including General Contractors&Operative Builders ^ (07)-Commodities Wholesaler/Reseller
^(03)-special Trade Construction O (OB)-Commodities Manufacturer
O (D4) -financial and Accounting Services O (09) -Medical Services
^ (OS) - ArchiteRural/Engineering and Surveying
1z. Principal Line of Business - Provide a brief description of the products and/or services provided by your business
13. Class and Item Codes - Please reference the NIGP Commodity Book at
http://www.window.state.tx.us/procurement//cam book/index.html and provide [he Class and
Item Code Numbers which represent the specific commodities and/orservices your
business can provide. To identify more than three class codes, please attach a separate
sheet using the same format.
Class # -Item # [Example: Class #450 -Item # 03, 04, 28, 25]
1a. Ownership - Provide the name, title, and percentage of ownership interest of all individuals and business entities
having an ownership interest in your business. Identify each individual's ethnicity and gender by using [he following
Ethnic Group Codes: Asian Pacific Americans -AS; Black Americans - SL; Hispanic Americans - Hl; Native Americans -
AI; American Woman - WO; and Caucasian - CA; and the following Gender Codes: Female - F; and Male - M. If an
individual's ethnicity does not meet any of the Ethnic Group Codes, Enter "Other" as the ethnicity.
Based on a 40-hour workweek, identify the number of hours each owner is present at the business' physical address
during the regularly established business hours, actively participating in the daily activities of the business operations.
Check the appropriate boxes to indicate if each individual is currently employed elsewhere and if they have ownership
interest in any other business entity.
Name Title %of Ethnicity/ pof Other Other fiusiness
First, MI, Last Ownership Gender Hours Employment Ownership
% ^ Y ^ N ^ Y ^ N
% ^ Y ^ N ^ Y ^ N
9'0 ^ Y ^N ^ Y ^N
9'0 ^ Y ^N ^ Y ^N
15. Buslne55 Responsibilities -Provide the name and title of [he individual(s) ultimately responsible Jor the Junctions identified below.
Functions
& Sign Financial Contracts
Name (First, Last)
Title
Negotiate and Sign Bids/Proposals
Hiring and Firing of Management Personnel
Supervision of Day-to-Day Operations
Affidavit of Eligibility -With my signature below, I attest that the information provided for the business entity described
In this application is correct. If the business entity is approved as a Local Business Enterprise by the City of Port Arthur,
I understand that this certification is not transferrable and that if the business operations cease to qualify, the
certification is subject to revocation.
Name of Eligible Applicant with Majority Ownership Interest
Subscribed and sworn to me the undersigned notary public on this
Signature of Eligible Applicant with Majority Ownership Interest
day of
Year
Notary Puhlic's Signature and Stamp/ Seal My commission expires on
