Attachment D - SBE Participation Schedule 1 and Schedule 2.pdf
PDF 82 KB Posted
- Attached to
- Audio Visual Technology Services State and local contract opportunity
- Solicitation number
- 1195-RFQ-25-4
- Issued by
- Palm Beach County, Florida
About this file
These documents are Schedule I and Schedule II forms for a Small Business Enterprise (SBE) Subcontractor/Supplier Participation Schedule for the City of Riviera Beach. The forms are blank templates designed to capture detailed information about potential subcontractors and their proposed participation in a municipal contract, including business association types, certification details, work percentages, and dollar amounts. The forms require bidders/proposers to list prime contractors and subcontractors, with space to specify the type of work to be performed, certification type, percentage of work, and associated dollar amounts.
The forms are specifically structured to promote small business participation, requiring signed statements of intent from SBE vendors certified in accordance with the City of Riviera Beach Code Ordinance. The documentation allows businesses to declare their organizational status (individual, partnership, corporation, or other), outline specific work descriptions, and provide agreed-upon pricing. Both forms emphasize transparency and verification, with explicit statements that the information provided will be relied upon during solicitation evaluation, and both require signatures from the SBE subcontractor, prime contractor, and include spaces for titles and dates to validate the submitted information.
View the file
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| Attachment A Forms - Proposer Required Forms v2_2025.pdf | ||
| Q_A Document 1.pdf | ||
| Solicitation.pdf | ||
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Text version
SCHEDULE 1 FORM
SMALL BUSINESS ENTERPRISE SUBCONTRACTOR/SUPPLIER PARTICIPATION SCHEDULE
SOLICITATION INFORMATION
CONTRACT NUMBER:
PROJECT NAME:
PROJECT START DATE:
BIDDER/PROPOSER:
ADDRESS:
CONTACT PERSON:
EMAIL ADDRESS:
PHONE NUMBER:
ORGANIZATION STATUS
BUSINESS ASSOCIATION:
BUSINESS NAME:
Type of Work to be Performed
CERTIFICATION
TYPE
% of
WORK
$ AMOUNT
Prime Bidder / Proposer % $ N/A
Subcontractor % $ N/A
Subcontractor % $ N/A
Subcontractor % $ N/A
Subcontractor % $ N/A
Subcontractor % $ N/A
TOTAL PARTICIPATION % & DOLLAR AMOUNT: 100% $ N/A
TOTAL CONTRACT AMOUNT: $N/A
BIDDER / PROPOSER SIGNATURE
The listing of SBE(s) shall constitute a representation by the bidder/proposer to the City that the bidder/proposer believes such SBE(s) to be technically and financially qualified and available to perform the work described. Bidders/Proposers are advised that the information contained herein may be verified. I certify that all information contained in this form is true and accurate to the best of my knowledge and will be relied upon when evaluating this solicitation.
Bidder / Proposer Signature:
Name & Title:
Date:
SCHEDULE II FORM
STATEMENT OF INTENT TO PERFORM AS A
SBE SUBCONTRACTOR/SUPPLIER
SOLICITATION INFORMATION
CONTRACT NUMBER:
PROJECT NAME:
PROJECT START DATE:
BIDDER/PROPOSER:
ADDRESS:
CONTACT PERSON:
EMAIL ADDRESS:
PHONE NUMBER:
A signed Statement of Intent to perform as a Small Business Enterprise (SBE) Subcontractor form must be completed by the Bidder and owner or authorized principal of each SBE firm listed in the Schedule.
STATEMENT OF INTENT
The undersigned is certified as an SBE vendor in accordance with the City of Riviera Beach Code Ordinance:
Yes No
(Name of SBE Subcontractor/Supplier) agrees to perform work on the above contract as a (check one):
INDIVIDUAL PARTNERSHIP CORPORATION OTHER
The SBE subcontractor will enter into a formal agreement with
(Name of Bidder/Proposer) conditioned upon the Bidder/Proposer executing a contract with the City.
DESCRIPTION OF WORK TO BE PERFORMED & VALUE
PLEASE PROVIDE THE DETAILS AND VALUE OF THE WORK TO BE PERFORMED:
ITEM NO. Type of Work Agreed Upon Price % of Work 1 $ N/A % 2 $ N/A % 3 $ N/A % 4 $ N/A %
TOTAL VALUE OF WORK: $ N/A %
SBE SUBCONTRACTOR / SUPPLIER SIGNATURE
I certify that all information contained in this form is true and accurate to the best of my knowledge and will be relied upon when evaluating this solicitation.
SBE Subcontractor (Signature) TITLE
Name of SBE Subcontractor (Print) DATE
Prime Contractor (Signature) TITLE
Prime Contractor (Print) DATE
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