6-Request For Bonus Points SBE-2 Form 10.pdf

PDF 114 KB Posted

Attached to
Hillsborough County Medical Examiner Facility Expansion
Solicitation number
RPS-26-00194
Issued by
Hillsborough County, Florida

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This is a Small Business Encouragement Program Request for Bonus Points form (SBE-2 Form) issued by Hillsborough County, Florida, for use in conjunction with the Medical Examiner Facility Expansion project estimated at $800,000.00. The form requires proposers to identify all registered Small Business Enterprise (SBE) subcontractors that will be utilized on the project, including the name of each SBE firm, the registering agency for each firm's SBE registration, and confirmation of whether a Letter of Intent has been executed with each named SBE firm. All SBEs must be registered with the Hillsborough County Small Business Encouragement Program or possess reciprocal registration as specified in the county's solicitation document. The form includes provisions for up to ten SBE subcontractors and requires attachment of current SBE registration documentation and executed Letters of Intent for each named firm.

By submitting this form, the proposer commits to subcontracting at least ten percent (10%) or more of the ultimate project fees to the named SBE firm(s) and certifies that all information provided is accurate. Failure to complete all requirements of the form may result in rejection of the bonus points request. The form requires signature by an authorized representative and must be completed in accordance with the county's solicitation requirements and the form Letter of Intent included within the solicitation documents.

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(10/2025) SBE-2 FORM

HILLSBOROUGH COUNTY

SMALL BUSINESS ENCOURAGEMENT PROGRAM

REQUEST FOR BONUS POINTS (SBE-2 FORM)

PROPOSAL NO.: __________ PROPOSER NAME: ______________________________________

List all registered Small Business Enterprise (SBE) subcontractors to be utilized on this project. Include the name of the/each registered SBE firm to be utilized, name(s) of the registering agency for the/each named firm’s SBE registration1 and acknowledge (Yes or No) if a Letter of Intent2 has been executed with the/each named SBE firm.

All SBEs must either be registered with the Hillsborough County Small Business Encouragement Program or have reciprocal registration as specified in the County’s solicitation document.

Failure to complete the requirements of this page may result in this request for Bonus Points being rejected.

Registered SBE Subcontractor(s) SBE Registering Agency1 Letter of Intent2

1Attach a copy of the/each named SBE firm’s current SBE registration. If the SBE firm is seeking reciprocal registration with the County, then a letter from the registering jurisdiction or copy of the registration document evidencing registration by the registering jurisdiction must be attached.

2Attach a copy of the Letter of Intent between the Proposer and the/each named SBE firm for the above referenced proposal.

**The form Letter of Intent is included with the County’s solicitation document and must be completed and provided to the County to ensure that all required information is provided.

By signing this form, I/the proposer, commit that at least ten percent (10%) or more of the ultimate fees for the above referenced proposal will be subcontracted to the named SBE firm(s).

I further acknowledge that all the foregoing information is true and correct to the best of my knowledge.

Authorized Representative - Signature Authorized Representative - Title

Authorized Representative - Printed Name Date

List all registered Small Business Enterprise SBE subcontractors to be utilized on this project Include the name:
PROPOSER NAME:
Registered SBE SubcontractorsRow1:
SBE Registering Agency1Row1:
Registered SBE SubcontractorsRow2:
SBE Registering Agency1Row2:
Registered SBE SubcontractorsRow3:
SBE Registering Agency1Row3:
Registered SBE SubcontractorsRow4:
SBE Registering Agency1Row4:
Registered SBE SubcontractorsRow5:
SBE Registering Agency1Row5:
Registered SBE SubcontractorsRow6:
SBE Registering Agency1Row6:
Registered SBE SubcontractorsRow7:
SBE Registering Agency1Row7:
Registered SBE SubcontractorsRow8:
SBE Registering Agency1Row8:
Registered SBE SubcontractorsRow9:
SBE Registering Agency1Row9:
Registered SBE SubcontractorsRow10:
SBE Registering Agency1Row10:
Authorized Representative Title:
Authorized Representative Printed Name:
Date:
Signature1_es_:signer:signature:
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