13-OESBD Affiliated Entities of the Principals Certification.pdf
PDF 60 KB Posted
- Solicitation number
- PNC2131298P1
- Issued by
- Broward County, Fort Lauderdale City, Florida
About this file
This is an Affiliated Entities Certification form required by the Office of Economic and Small Business Development for the Broward County Aviation Department's solicitation for consulting services in environmental compliance at Fort Lauderdale-Hollywood International Airport (FLL) and North Perry Airport (HWO) in Florida. All vendors submitting proposals must complete and submit this certification form either with their solicitation response or within three business days of the County's request; failure to submit timely may result in the vendor being deemed non-responsive. The form requires vendors to disclose the names and addresses of all affiliated entities of the vendor's principal(s) that have acted as prime vendors with the County over the five-year period preceding the solicitation opening deadline.
The County will review all disclosed affiliated entities for contract performance evaluations and compliance history with the Small Business Development Program, including County Business Enterprise (CBE) and Small Business Enterprise (SBE) goal attainment requirements. The vendor must certify either that no principal has prior affiliations meeting the criteria for affiliated entities, or provide the principal's name(s) and complete names and addresses of any affiliated entities that do meet the criteria. The County will consider the contract performance evaluations and compliance history of affiliated entities when determining vendor responsibility. The form must be signed by an authorized representative and includes fields for the vendor name, signatory's printed name, title, and date of certification.
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Text version
OFFICE OF ECONOMIC AND SMALL BUSINESS DEVELOPMENT REQUIREMENTS
AFFILIATED ENTITIES OF THE PRINCIPAL(S) CERTIFICATION
The completed form should be submitted with the solicitation response. If not submitted with the solicitation response, it must be submitted within three business days after of County’s request. Failure to timely submit may result in Vendor being deemed non-responsive.
a. All Vendors are required to disclose the names and addresses of Affiliated Entities (defined below) of the Vendor’s principal(s) over the last five years (from the solicitation opening deadline) that have acted as a prime vendor with the County.
b. The County will review all Affiliated Entities of the Vendor’s principal(s) for contract performance evaluations and the compliance history with the County’s Small Business Development Program, including County Business Enterprise (CBE) and Small Business Enterprise (SBE) goal attainment requirements. “Affiliated Entities” of the principal(s) are those entities related to the Vendor by the sharing of stock or other means of control, including but not limited to a subsidiary, parent, or sibling entity.
c. The County will consider the contract performance evaluations and the compliance history of the Affiliated Entities of the Vendor's principals in its review and determination of responsibility.
The Vendor hereby certifies that: (select one)
☐ No principal of the proposing Vendor has prior affiliations that meet the criteria defined as Affiliated Entities.
☐ Principal(s) listed below have prior affiliations that meet the criteria defined as Affiliated Entities.
Principal’s Name: Click or tap here to enter text.
Names and addresses of Affiliated Entities: Click or tap here to enter text.
Principal’s Name: Click or tap here to enter text.
Names and addresses of Affiliated Entities: Click or tap here to enter text.
Principal’s Name: Click or tap here to enter text.
Names and addresses of Affiliated Entities: Click or tap here to enter text.
Vendor Name: Click or tap here to enter text.
Signature: ______________________________ Printed Name: Click or tap here to enter text.
Title: Click or tap here to enter text.
Date: Click or tap to enter a date.
Form Date 9/23/26
File details come from the government source that posted it. Updated .