260013-Exhibit 12-SBE Program Participation Reporting Form.pdf

The document is a Maricopa County Small Business Enterprise (SBE) Program Participation Reporting Form used for tracking and reporting Small Business Enterprise involvement in county contracts. The form is designed to be submitted with each pay application or invoice, with a clear warning that submissions without this form may be rejected according to contract terms. The form requires detailed information about the prime consultant/contractor, including contact details, contract and project numbers, and a comprehensive breakdown of SBE firms utilized as subconsultants or subcontractors.

The form provides space for listing multiple SBE firms, their addresses, types of work performed, and the dollar amount paid to each SBE firm during the current pay application or invoice period. It also includes a checkbox option to certify that no SBE firms were utilized if applicable. The form is part of Maricopa County's efforts to track and potentially promote small business participation in county contracts, referencing Arizona Revised Statutes § 41-1001 as the legal basis for SBE firm classification. The document requires a signature, printed name, and telephone number to validate the reported information.