2-B. SMBE Certification Form.pdf
PDF 404 KB Posted
- Attached to
- Metal Fabrication - BID #26-0107
- Solicitation number
- 26-0107
- Issued by
- Sarasota County, Florida
About this file
This is a Small/Minority Business Enterprise Certification Form (Attachment B) issued by The School Board of Sarasota County, Florida for Metal Fabrication services under Bid #26-0107. The form requires bidders to identify whether they qualify as a Small Business Enterprise as defined by Florida Statute 288.703(1) or as a Minority Business Enterprise with categories including African American, Asian American, Woman Owned, Hispanic American, or Native American as defined in FS 288.703(2) and (3). Bidders must indicate certification by the State of Florida Department of Management Services Office of Supplier Diversity or provide alternative certification information, and those who are not small or minority business enterprises but plan to subcontract to such businesses must provide details including subcontractor names, designations, and estimated dollar values of services.
The form includes provisions for businesses that do not qualify as small or minority enterprises and do not intend to subcontract to such businesses, requiring them to indicate this status with a checkbox. The document requires completion of bidder identification information, authorized representative details, signature, and date fields. This certification form appears to be part of the school board's supplier diversity initiative to promote participation of small and minority-owned businesses in public contracting opportunities for metal fabrication services.
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Text version
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
METAL FABRICATION – BID #26-0107
| 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 |
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