1-B. SMBE Certification Form.pdf

181 KB Posted

Attached to
MOVING SERVICES - BID #26-0012
Solicitation number
26-0012
Issued by
Sarasota County, Florida

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This document is a Small/Minority Business Enterprise Certification Form issued by the School Board of Sarasota County, Florida for Moving Services, specifically Bid #26-0012. The form is designed to collect information about small and minority-owned businesses participating in the bid process, allowing businesses to self-identify as Small Business Enterprises or Minority Business Enterprises across various categories including African American, Asian American, Woman Owned, Hispanic American, and Native American businesses.

The certification form provides options for businesses to indicate their minority/small business status, including certification through the State of Florida's Department of Management Services, Office of Supplier Diversity. Additionally, the form includes a section for bidders who are not small or minority businesses to list potential subcontractors, their designations, and estimated dollar values of services. Bidders must complete the form by providing their company name, bid number, authorized representative details, and signature, with an option to indicate if they do not qualify as a small/minority business enterprise or intend to subcontract with such businesses.

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ATTACHMENT B

SMALL/MINORITY BUSINESS ENTERPRISE CERTIFICATION FORM

Please complete if you are either a:

Small Business Enterprise, as defined by FS 288.703 (1)

Or a:

Minority Business Enterprise, Please select one or more as applicable:

African American Asian American Woman Owned Hispanic American Native American

As defined in FS 288.703 (2) and (3), and that it has been certified by one of the following agencies as an MBE:

State of Florida, Department of Management Services, Office of Supplier Diversity

If not by DMS, who/self-report: _

If you are not a small or minority business enterprise, but intend to subcontract a portion of services or work described in this ITB to a small or minority business enterprise, please provide the following information:

Subcontractor Name Small/MBE Designation Estimated Dollar Value of Services

1. __ _ _ _

2. __ _ _

3. __ _ _

NAME OF BIDDER BID # AND TITLE

PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

SIGNATURE DATE

If Bidder is NOT a small or minority business enterprise and/or does not intend to subcontract a portion of the services or work described in this ITB to a S/MBE, then Bidder shall indicate here:

THE SCHOOL BOARD OF SARASOTA COUNTY, FLORIDA

MOVING SERVICES - BID #26-0012

Small Business Enterprise as defined by FS 288703 1: Off
Minority Business Enterprise: Off
African American: Off
Asian American: Off
Woman Owned: Off
Hispanic American: Off
Native American: Off
State of Florida Department of Management Services Office of Supplier Diversity: Off
If not by DMS whoselfreport: Off
undefined:
undefined_2:
SmallMBE Designation:
Estimated Dollar Value of Services:
1:
2:
1_2:
2_2:
NAME OF BIDDER BID AND TITLE:
PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE:
SIGNATURE DATE:
Text5:
Text6:
Text7:
Check Box3: Off

File details come from the government source that posted it. Updated .