3-OESBD Affiliated Entities of the Principals Certification.docx
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- Solicitation number
- GEN2129832P1
- Issued by
- Broward County, Fort Lauderdale City, Florida
About this file
This is a certification form from the Office of Economic and Small Business Development (OESBD) for Broward County, Florida, required as part of the solicitation response for the Management of Airport Rental Car Center Fueling Facility at Fort Lauderdale-Hollywood International Airport. Vendors must disclose all affiliated entities of their principal(s) that have served as prime vendors with the County over the preceding five years from the solicitation opening deadline. The County will review these affiliated entities for contract performance evaluations and compliance history with the Small Business Development Program, including County Business Enterprise (CBE), Disadvantaged Business Enterprise (DBE), and Small Business Enterprise (SBE) goal attainment requirements. The completed form must be submitted with the solicitation response or within three business days of the County's request; failure to timely submit may result in the vendor being deemed non-responsive.
The certification requires vendors to identify whether their principal(s) have prior affiliations meeting the definition of affiliated entities—those related by shared stock or other means of control, including subsidiaries, parent companies, or sibling entities. Vendors must list the principal's name and the names and addresses of any affiliated entities in the designated fields. The County will consider the contract performance evaluations and compliance history of affiliated entities in determining vendor responsibility. The form is dated September 9, 2024, and must be signed by an authorized representative of the vendor, with printed name, title, and date provided.
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Text version
OFFICE OF ECONOMIC AND SMALL BUSINESS DEVELOPMENT REQUIREMENTS
AFFILIATED ENTITIES OF THE PRINCIPAL(S) CERTIFICATION
The completed form should be submitted with the solicitation response. If not submitted with the solicitation response, it must be submitted within three business days after of County’s request. Failure to timely submit may result in Vendor being deemed non-responsive.
a. All Vendors are required to disclose the names and addresses of Affiliated Entities (defined below) of the Vendor’s principal(s) over the last five years (from the solicitation opening deadline) that have acted as a prime vendor with the County.
b. The County will review all Affiliated Entities of the Vendor’s principal(s) for contract performance evaluations and the compliance history with the County’s Small Business Development Program, including County Business Enterprise (CBE), Disadvantaged Business Enterprise (DBE) and Small Business Enterprise (SBE) goal attainment requirements. “Affiliated Entities” of the principal(s) are those entities related to the Vendor by the sharing of stock or other means of control, including but not limited to a subsidiary, parent, or sibling entity.
c. The County will consider the contract performance evaluations and the compliance history of the Affiliated Entities of the Vendor's principals in its review and determination of responsibility.
The Vendor hereby certifies that: (select one)
☐ No principal of the proposing Vendor has prior affiliations that meet the criteria defined as Affiliated Entities.
☐ Principal(s) listed below have prior affiliations that meet the criteria defined as Affiliated Entities.
Principal’s Name: Click or tap here to enter text.
Names and addresses of Affiliated Entities: Click or tap here to enter text.
Principal’s Name: Click or tap here to enter text.
Names and addresses of Affiliated Entities: Click or tap here to enter text.
Principal’s Name: Click or tap here to enter text.
Names and addresses of Affiliated Entities: Click or tap here to enter text.
Vendor Name: Click or tap here to enter text.
Signature: ______________________________ Printed Name: Click or tap here to enter text.
Title: Click or tap here to enter text.
Date: Click or tap to enter a date.
Form Date 9/9/24
File details come from the government source that posted it. Updated .