3-OESBD Affiliated Entities of the Principals Certification.docx
DOCX document 39 KB Posted
- Solicitation number
- PNC2131343P1
- Issued by
- Broward County, Florida
About this file
This is a certification form issued by the Office of Economic and Small Business Development (OESBD) for Broward County, Florida, related to a lead emissions screening project at North Perry Airport (HWO). The form requires all vendors submitting proposals to disclose affiliated entities of the vendor's principals that have acted as prime vendors with the County over the preceding five years from the solicitation opening deadline. Vendors must certify either that no principals have prior affiliations meeting the defined criteria or provide detailed information on affiliated entities, including the principal's name and the names and addresses of all related entities. The completed certification form must be submitted with the solicitation response, or if omitted, within three business days of the County's request; failure to submit timely may result in the vendor being deemed non-responsive.
The County will review all disclosed affiliated entities for contract performance evaluations and compliance history with the Small Business Development Program, specifically examining County Business Enterprise (CBE), Disadvantaged Business Enterprise (DBE), and Small Business Enterprise (SBE) goal attainment requirements. Affiliated entities are defined as those related to the vendor through stock ownership or other means of control, including subsidiaries, parent companies, or sibling entities. The contract performance evaluations and compliance history of affiliated entities will be considered by the County in its determination of vendor responsibility. The form, dated September 9, 2024, requires the vendor's authorized representative to sign and provide printed name, title, and date of certification.
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| 9-Location Certification - RFP-RFQ-RLI.docx | DOCX document | |
| 14-1. Scope of Work PNC2131343P1.pdf | ||
| 12-Evaluation Criteria PNC2131343P1.pdf | ||
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| 10-Vendor Questionnaire and Standard Certifications - RFP-RFQ-RLI.docx | DOCX document | |
| 11-Vendor Reference Verification - PNC2131343P1.docx | DOCX document | |
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| 15-Appendix - Detailed Scope of Work Lead Emission Screening.pdf | ||
| 13-Insurance Requirements PNP2131343P1.pdf | ||
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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 .