23-CBE - Monthly Utilization Report Form Addendum 1.pdf
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- Solicitation number
- PNC2132449P1
- Issued by
- Broward County, Florida
About this file
This document is a County Business Enterprise (CBE) Monthly Utilization Report Form Addendum 1, applicable to Broward County, Florida contracts. The form serves as a compliance tracking mechanism for prime contractors to report subcontracting activities and payment distribution to certified CBE firms on county projects. The document requires submission of detailed information regarding each CBE subcontractor engaged on a project, including the firm's address, description of work performed, original and revised agreed prices, percentage of work completed, and amounts paid during the reporting period and cumulatively to date. The form must be completed monthly and submitted to the Project Manager for verification by the Office of Economic and Small Business Development. The addendum expands the original form to accommodate up to four CBE subcontractors per reporting period, with identical data fields for each firm listed.
The report serves as a verification mechanism to ensure compliance with CBE participation commitments established at contract award. Prime contractors must certify the accuracy of all submitted information and track cumulative payments made to CBE firms throughout the contract performance period. The form requires identification of the prime contractor contact information, contract number, total contract amount, amount paid to the prime, project description, and project completion date. Contractors are required to maintain detailed subcontracting records demonstrating both the original and any revised pricing agreements with CBE firms, enabling the county to verify that committed participation levels are being met and that payments are distributed appropriately throughout the project lifecycle.
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Text version
COUNTY BUSINESS ENTERPRISE (CBE)
MONTHLY UTILIZATION REPORT
Report No.___________ CBE Commitment ____%
Rev.: June 2018 Compliance Form No. 005
Contract #: _____________________ Contract Amount: ______________________ Amt. Paid to Prime: ______________________
Project Description: ____________________________________ Project Completion Date: _______ Period Ending Date: _______
Prime Contractor: ______________________________________ Contact Person: ________________________________________
Email: ________________________________________________ Phone: ______________________ Fax: _____________________
SUBCONTRACTING INFORMATION
CBE Firm(s) Address Description of Work Original Agreed
Price Revised Agreed
Price % of work Completed to Date Amount Paid This Period
Amount Paid to Date
Total Amount Paid to CBE Firm(s) to Date:
I certify that the information submitted in this report is in fact true and correct to the best of my knowledge.
Signature: _____________________________________________ Title: ____________________________________________ Date: ________________________ This completed form must be submitted to the Project Manager.
Note: The information provided herein is subject to verification by the Office of Economic and Small Business Development.
Addendum No. 1
| Report No: |
| CBE Commitment: |
| Contract: |
| Contract Amount: |
| Amt Paid to Prime: |
| Project Description: |
| Project Completion Date: |
| Period Ending Date: |
| Prime Contractor: |
| Contact Person: |
| Email: |
| Phone: |
| Fax: |
| CBE FirmsRow1: |
| AddressRow1: |
| Description of WorkRow1: |
| Original Agreed PriceRow1: |
| Revised Agreed PriceRow1: |
| of work Completed to DateRow1: |
| Amount Paid This PeriodRow1: |
| Amount Paid to DateRow1: |
| CBE FirmsRow2: |
| AddressRow2: |
| Description of WorkRow2: |
| Original Agreed PriceRow2: |
| Revised Agreed PriceRow2: |
| of work Completed to DateRow2: |
| Amount Paid This PeriodRow2: |
| Amount Paid to DateRow2: |
| CBE FirmsRow3: |
| AddressRow3: |
| Description of WorkRow3: |
| Original Agreed PriceRow3: |
| Revised Agreed PriceRow3: |
| of work Completed to DateRow3: |
| Amount Paid This PeriodRow3: |
| Amount Paid to DateRow3: |
| CBE FirmsRow4: |
| AddressRow4: |
| Description of WorkRow4: |
| Original Agreed PriceRow4: |
| Revised Agreed PriceRow4: |
| of work Completed to DateRow4: |
| Amount Paid This PeriodRow4: |
| Amount Paid to DateRow4: |
| Amount Paid to DateTotal Amount Paid to CBE Firms to Date: 0 |
| Title: |
| Date: |
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