APPENDIX_7_-_SBE_COMPLIANCE_FORM.pdf

PDF 160 KB Posted

Attached to
Palm Harbor Recreation Center Addition State and local contract opportunity
Solicitation number
26-0011-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 ensure compliance with small business participation goals. The form provides space for the prime contractor to list multiple subcontractors, including their company names, addresses, contact information, and the dollar amount of subcontracted work. The form requires the prime contractor to certify the accuracy of the information and acknowledges that the form will become part of the contract with Pinellas County.

The form includes a section for Pinellas County purchasing staff to review and verify the bidder's compliance with the SBE goals outlined in the Invitation to Bid. The document allows for detailed documentation of subcontractor participation, with multiple entries for different subcontractors and their respective work amounts. The form emphasizes transparency and accountability in the subcontracting process, with a formal certification by the authorized representative of the prime contractor.

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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 .