B._SMBE_Certification_Form.pdf

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Attached to
T-Shirt and Shorts - Bid #26-0050
Solicitation number
26-0050
Issued by
Sarasota County, Florida

About this file

This is a Small/Minority Business Enterprise Certification Form submitted to the School Board of Sarasota County, Florida for Bid #26-0050, which concerns the procurement of t-shirts and shorts. The School Board of Sarasota County intends to establish a firm fixed manufacturer discount for a one-year period for the purchase of physical education uniforms, club shirts, and various function shirts to be distributed across approximately 60 locations throughout the Sarasota County School District, including schools and departments. The form serves as an attachment to the bid solicitation and requires bidders to certify their small or minority business enterprise status or to disclose any subcontracting arrangements with certified S/MBE firms.

Bidders must indicate whether they qualify as a Small Business Enterprise as defined by Florida Statute 288.703(1) or as a Minority Business Enterprise as defined by FS 288.703(2) and (3), with MBE categories including African American, Asian American, Woman Owned, Hispanic American, or Native American-owned businesses. If the bidder is not an S/MBE but intends to subcontract a portion of the work to certified S/MBE firms, the bidder must provide the subcontractor name, S/MBE designation, and estimated dollar value of services. The form requires the authorized representative of the bidding entity to provide their printed name, title, signature, and date of certification.

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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

T-SHIRTS AND SHORTS BID #26-0050

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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