APPENDIX_7_-_SBE_COMPLIANCE_FORM.pdf
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- Solicitation number
- 25-0681-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, designed to track subcontractor information and compliance with small business participation goals for a county procurement opportunity. The form provides space for the prime contractor to list multiple subcontractors, including their company names, addresses, contact information, and the amount of subcontracted work for each. The form requires the prime contractor to certify the accuracy of the information and includes a section for Pinellas County purchasing staff to review and confirm compliance with the SBE goals specified in the Invitation to Bid.
The form is structured to ensure transparency and accountability in subcontracting, with designated areas for recording detailed subcontractor information and a mandatory certification statement. It allows Pinellas County to verify that bidders are meeting the specified Small Business Enterprise participation requirements for the project. The form includes checkboxes for county staff to indicate whether the bidder is in compliance with the SBE goals, and provides space for the purchasing staff member to initial and date their review.
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Text version
APPENDIX 7 - SBE COMPLIANCE FORM
APPENDIX 7 – SBE COMPLIANCE FORM
PRIME CONTRACTOR NAME:
SUBCONTRACTOR(S) INFORMATION:
COMPANY: COMPANY:
ADDRESS: ADDRESS:
AMOUNT OF
SUBCONTRACTED
WORK: $
AMOUNT OF
SUBCONTRACTED
WORK: $
CONTACT: CONTACT:
EMAIL: EMAIL:
TELEPHONE: TELEPHONE:
COMPANY: COMPANY:
ADDRESS: ADDRESS:
AMOUNT OF
SUBCONTRACTED
WORK: $
AMOUNT OF
SUBCONTRACTED
WORK: $
CONTACT: CONTACT:
EMAIL: EMAIL:
TELEPHONE: TELEPHONE:
I certify that the information included in this Compliance Form is true and complete to the best of my knowledge and belief. I further understand and agree that this Compliance Form shall become a part of my contract with Pinellas County.
FOR PINELLAS COUNTY USE ONLY:
I have reviewed this Compliance Form and found the Bidder IS IS NOT in compliance with the Invitation to Bid SBE goals.
Purchasing Staff Member:
Initials: Date:
Name and Title of Authorized Representative:
Signature:
MANDATORY SBE PROJECT GOAL PERCENTAGE LISTED IN SPECIAL CONDITIONS SECTION
File details come from the government source that posted it. Updated .