2-B. SMBE Certification Form.pdf
PDF 408 KB Posted
- Solicitation number
- 26-0112
- Issued by
- Sarasota County, Florida
About this file
This document is a Small/Minority Business Enterprise Certification Form for the School Board of Sarasota County, Florida, related to a bid (#26-0112) for Commercial Kitchen Refrigeration Maintenance & Installation Services. The form allows bidders to self-certify as a Small Business Enterprise or Minority Business Enterprise, with options to identify specific minority designations including African American, Asian American, Woman Owned, Hispanic American, and Native American businesses. The certification can be verified through the State of Florida's Department of Management Services, Office of Supplier Diversity.
The form provides an opportunity for businesses that are not classified as small or minority enterprises to indicate their intent to subcontract portions of the work to such businesses, with space to list up to three subcontractors, their designation, and estimated dollar value of services. Bidders who are not small or minority businesses and do not plan to subcontract to such enterprises are required to indicate this on the form. The document includes signature lines for an authorized representative to complete the certification, demonstrating the bidder's commitment to transparency regarding their business classification and potential subcontracting plans.
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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
COMMERCIAL KITCHEN REFRIGERATION MAINTENANCE &
INSTALLATION SERVICES - BID #26-0112
| 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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