3-OESBD Affiliated Entities of the Principals Certification.docx

DOCX document 39 KB Posted

Attached to
Shuttle Bus and Other Transportation Services for Fort Lauderdale-Hollywood International Airport
Solicitation number
GEN2129760P1
Issued by
Broward County, Fort Lauderdale City, Florida

About this file

This is an Affiliated Entities of the Principal(s) Certification form issued by the Office of Economic and Small Business Development (OESBD) for Broward County, Florida, in connection with the Shuttle Bus and Other Transportation Services solicitation for Fort Lauderdale-Hollywood International Airport. The certification requires all vendors to disclose the names and addresses of any affiliated entities of the vendor's principal(s) that have served as prime vendors with the County within the five-year period preceding the solicitation opening deadline. Vendors must submit this completed form with their solicitation response or 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, including County Business Enterprise (CBE), Disadvantaged Business Enterprise (DBE), and Small Business Enterprise (SBE) goal attainment requirements. The vendor must certify whether principals have prior affiliations meeting the definition of affiliated entities—defined as entities related by stock ownership or other means of control, including subsidiaries, parent companies, or sibling entities. The County will consider the contract performance and compliance history of affiliated entities in determining vendor responsibility. The form was dated September 9, 2024, and requires the vendor's authorized representative to provide their signature, printed name, title, and date of certification.

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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 .