B._SMBE_Certification_Form.pdf
PDF 503 KB Posted
- Solicitation number
- 27-0295
- Issued by
- Sarasota County, Florida
About this file
This is a Small/Minority Business Enterprise Certification Form submitted by bidders to The School Board of Sarasota County, Florida for Bid #27-0295, which concerns the purchase of used vehicles for the Suncoast Technical College Automotive Program. Bidders must complete this form to indicate whether they qualify as a Small Business Enterprise (SBE) as defined by Florida Statute 288.703(1) or a Minority Business Enterprise (MBE) as defined by Florida Statute 288.703(2) and (3). The form requires bidders to identify their classification status, including options for African American, Asian American, Woman Owned, Hispanic American, or Native American designations, and to confirm certification through the State of Florida Department of Management Services, Office of Supplier Diversity, or through self-reporting if certified by another agency.
For bidders that do not qualify as SBEs or MBEs but intend to subcontract a portion of the work to such enterprises, the form requires disclosure of subcontractor names, their SBE/MBE designations, and estimated dollar values for services provided. The form includes signature blocks for authorized representatives and must be completed and returned as part of the bid package. Bidders who are neither small nor minority business enterprises and do not plan to utilize SBE/MBE subcontractors must indicate this status on the form. The contract opportunity involves purchasing used vehicles from local automotive dealers to support classroom instruction in various vehicle makes and models from major manufacturers including Ford, Chevrolet, General Motors, Subaru, Honda, Nissan, and Toyota, with acceptance of wholesale, auction, and donated vehicles.
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Text version
ATTACHMENT B
SMALL/MINORITY BUSINESS ENTERPRISE CERTIFICATION FORM
Please complete if you are either a:
Small Business Enterprise, as defined by FS 288.703 (1)
Or a:
Minority Business Enterprise, Please select one or more as applicable:
African American Asian American Woman Owned Hispanic American Native American
As defined in FS 288.703 (2) and (3), and that it has been certified by one of the following agencies as an MBE:
State of Florida, Department of Management Services, Office of Supplier Diversity
If not by DMS, who/self-report: _
If you are not a small or minority business enterprise, but intend to subcontract a portion of services or work described in this ITB to a small or minority business enterprise, please provide the following information:
Subcontractor Name Small/MBE Designation Estimated Dollar Value of Services
1. __ _ _ _
2. __ _ _
3. __ _ _
NAME OF BIDDER BID # AND TITLE
PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
SIGNATURE DATE
If Bidder is NOT a small or minority business enterprise and/or does not intend to subcontract a portion of the services or work described in this ITB to a S/MBE, then Bidder shall indicate here:
THE SCHOOL BOARD OF SARASOTA COUNTY, FLORIDA
SUNCOAST TECHNICAL COLLEGE USED VEHICLES FOR AUTOMOTIVE PROGRAM - BID #27-0295
| Small Business Enterprise as defined by FS 288703 1: Off |
| Minority Business Enterprise: Off |
| African American: Off |
| Asian American: Off |
| Woman Owned: Off |
| Hispanic American: Off |
| Native American: Off |
| State of Florida Department of Management Services Office of Supplier Diversity: Off |
| If not by DMS whoselfreport: Off |
| undefined: |
| undefined_2: |
| SmallMBE Designation: |
| Estimated Dollar Value of Services: |
| 1: |
| 2: |
| 1_2: |
| 2_2: |
| NAME OF BIDDER BID AND TITLE: |
| PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE: |
| SIGNATURE DATE: |
| Text5: |
| Text6: |
| Text7: |
| Check Box3: Off |
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