Houston First Application and Affidavit Form

Hire Houston First Application and Affidavit

Thank you for your interest in the Hire Houston First initiative. It is the policy of the City of Houston as defined in Chapter 15, Article XI, to use the City’s spending powers in a manner that promotes fiscal responsibility and maximizes the effectiveness of local tax dollars by ensuring a portion of citizens’ tax dollars remain in the local economy for economic benefit of the citizens by utilizing all available legal opportunities to contract with city and/or local businesses.

Businesses interested in becoming eligible to participate in the Hire Houston First initiative must complete this application and sign the attached affidavit. Only businesses that meet the requirements will be eligible to participate in the Hire Houston First initiative. A completed HHF application is NOT evidence of designation under the Hire Houston First initiative. An applicant’s eligibility must be confirmed in writing by the Office of Business Opportunity.

Definitions:

A. City Business means a business with a principal place of business within city limits.

B. Local Area means the Houston-Sugar Land-Baytown metropolitan statistical area, as defined by the Office of Management and Budget within the Executive Office of the President of the United States and includes the counties of Harris, Fort Bend, Montgomery, Brazoria, Galveston, Chambers, Waller, Liberty, Austin and San Jacinto.

C. Local Business means a business with a principal place of business in the local area.

D. Principal Place of Business means the business must be either: (1) headquartered in the incorporated limits of the city or the local area, as applicable; or (2) have an established place or places of business in the incorporated limits of the city or the local area from which 20% or more of the entity’s workforce are regularly based, and from which a substantial role in the entity’s performance of a commercially useful function or a substantial part of its operations is conducted. A location utilized solely as a post office box, mail drop or telephone message center or any combination thereof, with no other substantial work function, shall not be construed as a Principal Place of Business.

E. Headquartered means the location where an entity’s leadership directs, controls, and coordinates the entity’s activities.

Application

Please complete the following form/affidavit and submit it to the Office of Business Opportunity, Houston Business Solutions Center located at 611 Walker, Lobby Level, and Houston, TX 77002 (832) 393-0954. Applications may be submitted via e-mail to houstonBSC@houstontx.gov or faxed to 832.393.0650. Incomplete applications and affidavits will not be processed. Please answer all questions.

1. Application Date:

2. Company is applying as (Check at least one):

City Business (CB) with a principal place of business within the city limits from which a substantial role in the entity’s performance of a commercially useful function or a substantial part of its operations is conducted as defined in Chapter 15, Article XI.

Local Business (LB) with a principal place of business in the local county area from which a substantial role in the entity’s performance of a commercially useful function or a substantial part of its operations is conducted as defined in Chapter 15, Article XI.

3. Legal Name of Owner or CEO:

4. Legal Name of Company:

5. Business Address

6. Mailing Address

10. Describe the primary activities of your business

11. In accordance with the aforementioned definition for “Headquartered”, is your business’ headquarters or corporate office located in one of the following (10) counties?

Yes No

If yes, check the location below for the firm’s headquarters

12. In the fields provided insert the number of employees based in each of the following (10) counties.

13. List all business locations INSIDE city limits and in the (10) county local area as well as addresses, primary activities and number of employees at each location.

(If locations exceed boxes provided, attach document with locations/employees to application)

14. List all company locations OUTSIDE the (10) county local area, including headquarters locations, as well as addresses, primary activities and number of employees at each location.

(If locations exceed boxes provided, attach document with locations/employees to application)

15. What is the total number of employees in the entire company (including parent and/or subsidiaries)?

16. Is the company represented on this application an independent or dependent subsidiary of a company with headquarters located outside the (10) county local area? (Check One)

No, not a subsidiary of any company.

Yes, An independent subsidiary. Please submit a copy of the firm’s most recent Corporate U.S. Federal Income Tax Return and any other documentation necessary to show independence from the parent company.

Yes, A dependent subsidiary.

A. What is the total number of employees inclusive of the company represented on this application and the parent company within the (10) county local area?

Hire Houston First Affidavit

I certify and affirm that my business

Address

Is not a location utilized solely as a post office box, mail drop or telephone message center or any combination thereof, with no other substantial work function.

The undersigned swear/affirm that the foregoing information and statements are true and correct with regard to the employee breakdown of the company’s work force, location, and principal place of business. In addition, the undersigned gives permission to the City of Houston to conduct random audits to ensure compliance with the Hire Houston First initiative under Chapter 15, Article XI.

On this day before me appeared (name) with proper identification, who being duly sworn, did execute the foregoing affidavit and did aver that he or she was properly authorized to execute this affidavit and did so as his or her free act/deed.