Attachment N.pdf
PDF 231 KB Posted
- Attached to
- Senior Community Service Employement Program
- Solicitation number
- RFP-11545
- Issued by
- Leon County, Florida
About this file
This document is Attachment N, a Certified Minority Business Subcontractor Expenditures (CMBE) form required by the Florida Department of Elder Affairs (DOEA) for contract number 24-RFP-001-JT. The form must accompany all invoices submitted to DOEA and requires contractors to report all expenditures made to certified minority business subcontractors during the invoice period. The form includes fields for contractor name, contract number, reporting period, and DOEA contract manager information.
The form requires detailed reporting of subcontractor information including the subcontractor's name, FEID number, CMBE number, and expenditure amounts. Contractors can verify subcontractor certification status through the Florida Office of Supplier Diversity directory at osd.dms.myflorida.com/directories. Completed forms must be submitted to the CMBE Coordinator in Contract Administration & Purchasing in Tallahassee, with questions directed to 850-414-2153.
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Text version
DOEA Solicitation No.: 24-RFP-001- JT Page 1 of 2
ATTACHMENT N
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES (CMBE FORM)
CMBE FORM MUST ACCOMPANY INVOICES SUBMITTED TO DOEA
CONTRACTOR NAME: __________________________________________________
DOEA CONTRACT NUMBER: __________________
*REPORTING PERIOD-FROM: ________________ TO: __________________
*(DATE RANGE OF RENDERED SERVICES, MUST MATCH INVOICE SUBMITTED TO DOEA)
DOEA CONTRACT MANAGER: ________________________________________
REPORT ALL EXPENDITURES MADE TO CERTIFIED MINORITY BUSINESS (SUBCONTRACTORS).
CONTACT DOEA CMBE COORDINATOR FOR ANY QUESTIONS, AT 850-414-2153
SUBCONTRACTOR NAME SUBCONTRACTOR’S
FEID
CMBE EXPENDITURES
DOEA USE ONLY -- REPORTING ENTITY (DIVISION, OFFICE, ETC)
SEND COMPLETED FORMS VIA INTEROFFICE MAIL TO: JUSTIN TAYLOR
CMBE COORDINATOR, CONTRACT ADMINISTRATION & PURCHASING, TALLAHASSEE, FLORIDA 32399-
7000.
DOEA Solicitation No.: 24-RFP-001- JT Page 2 of 2
If unsure if subcontractor is a certified minority supplier, click on the hyperlink below. Enter the name of the supplier, click
“search”. Only Certified Minority Business Entities will be displayed.
https://osd.dms.myflorida.com/directories
INSTRUCTIONS
(A) ENTER THE COMPANY NAME AS IT APPEARS ON YOUR DOEA CONTRACT.
(B) ENTER THE DOEA CONTRACT NUMBER.
(C) ENTER THE SERVICE PERIOD MATCHING THE CURRENT INVOICE’S SERVICE PERIOD.
(D) ENTER ALL CERTIFIED MINORITY BUSINESS EXPENDITURES FOR THE TIME PERIOD COVERED BY
THE INVOICE:
1. ENTER CERTIFIED MINORITY BUSINESS NAME.
2. ENTER THE CERTIFIED MINORITY BUSINESS FEID NUMBER.
3. ENTER THE CERTIFIED MINORITY BUSINESS CMBE NUMBER.
4. ENTER THE AMOUNT EXPENDED WITH THE CERTIFIED MINORITY BUSINESS FOR THE TIME
PERIOD COVERED BY THE INVOICE.
(E) CMBE FORM MUST ACCOMPANY INVOICE PACKAGE SUBMITTED TO DOEA FINANCIAL
ADMINISTRATION FOR PROCESSING.
(F) FINANCIAL ADMINISTRATION WILL FORWARD ALL COMPLETED CMBE FORMS TO CONTRACT
ADMINISTRATION & PURCHASING OFFICE
https://osd.dms.myflorida.com/directories
File details come from the government source that posted it. Updated .