3-OESBD Affiliated Entities of the Principals Certification.docx

DOCX document 39 KB Posted

Attached to
Roofing and Waterproofing Consultant Services
Solicitation number
PNC2130470P1
Issued by
Broward County, Florida

About this file

This is an Affiliated Entities Certification form issued by the Office of Economic and Small Business Development for Broward County, Florida, applicable to the Roofing and Waterproofing Consultant Services solicitation. The form requires vendors to disclose the names and addresses of all affiliated entities of the vendor's principal(s) that have acted as prime vendors with the County within the five years preceding the solicitation opening deadline. Vendors must submit the completed certification with their solicitation response, or if omitted, within three business days of the County's request. Failure to submit the form timely may result in the vendor being deemed non-responsive and ineligible for award consideration.

The County will review all disclosed 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. Affiliated entities are defined as those related to the vendor through shared stock ownership or other means of control, including subsidiaries, parent entities, or sibling entities. The vendor must certify either that no principal has prior affiliations meeting the criteria or provide specific information about principals with affiliated entities. The County will use the contract performance evaluations and compliance history of affiliated entities in determining vendor responsibility for award purposes. The form was dated September 9, 2024.

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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 .