3-B. SMBE Certification Form.pdf
PDF 182 KB Posted
- Attached to
- FOOD SERVICE EQUIPMENT & COMMERCIAL GAS OPERATED APPLIANCE REPAIR SERVICES - BID #26-0154
- Solicitation number
- 26-0154
- Issued by
- Sarasota County, Florida
About this file
This document is a Small/Minority Business Enterprise Certification Form issued by the School Board of Sarasota County, Florida for a bid (#26-0154) related to Food Service Equipment & Commercial Gas Operated Appliance Repair Services. The form is designed to capture information about small and minority business enterprises participating in the bidding process, allowing vendors to self-identify as a Small Business Enterprise or Minority Business Enterprise across several categories including African American, Asian American, Woman Owned, Hispanic American, and Native American owned businesses.
The certification form provides an opportunity for bidders to declare their business classification and, if not a small or minority business enterprise, to list potential subcontractors from these categories along with their estimated dollar value of services. The document references Florida Statutes 288.703 (1), (2), and (3) as the legal basis for defining these business classifications, with certification potentially available through the State of Florida's Department of Management Services, Office of Supplier Diversity. Bidders who do not qualify as a small or minority business enterprise are required to indicate this status on the form, emphasizing the bid's commitment to supporting diverse business participation.
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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
FOOD SERVICE EQUIPMENT & COMMERCIAL GAS OPERATED APPLIANCE
REPAIR SERVICES – BID #26-0154
| 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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