ITB202608_CDBG_Infrastructure_Improvement_Project__Exhibit_W.pdf
PDF 180 KB Posted
- Attached to
- Infrastructure Improvement Project
- Solicitation number
- ITB-2026-08 CDBG
- Issued by
- Santa Rosa County, Florida
About this file
This document is a Section 3 Business Status Certification Form (Form SC-54) issued by the Small Cities Community Development Block Grant Program, applicable to the City of Milton, Florida's Infrastructure Improvement Project (ITB-2026-08). The form serves as documentation for businesses seeking to claim Section 3 status and participate in CDBG-funded projects. Bidders must submit sealed bids for the 2026-08 Infrastructure Improvement Project, with a mandatory pre-bid conference and site visit scheduled for 11:00 A.M. on Tuesday, July 21, 2026, at the City of Milton Council Chambers located at 6738 Dixon Street, Milton, FL 32570.
Businesses claiming Section 3 status must provide supporting documentation through one of three eligibility pathways: (1) resident-owned enterprise status verified through residential lease, public assistance receipt, or equivalent evidence; (2) subcontracting of at least 25 percent of the awarded contract amount to qualified Section 3 businesses; or (3) demonstration that at least 30 percent of their current workforce qualifies as Section 3 residents or qualified within three years of employment. The executing business must provide complete employee rosters with corresponding Section 3 status documentation. All completed forms and supporting documentation must be maintained by the local government in CDBG project files for monitoring review purposes. Businesses must certify the accuracy of submitted information through authorized signature.
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Text version
Small Cities Community Development Block Grant Program Form SC-54
Documentation for Business Claiming Section 3 Status
73C-23.0051, FAC
Name of Business:
DUNS Number of Business:
Address of Business:
Type of Business: Corporation Partnership
Sole Proprietorship Joint Venture
Attached is the following documentation as evidence of our Section 3 status:
For a business claiming status as a Section 3 resident-owned enterprise.
Copy of resident lease Copy of receipt of public assistance
Copy of evidence of participation in a public Other evidence assistance program
For a business claiming Section 3 status by subcontracting 25 percent of the dollar amount awarded to qualified Section 3 businesses.
List of Section 3 subcontractor(s) and subcontract amount(s).
For a business claiming Section 3 status based on at least 30 percent of their workforce currently qualifying as Section 3 residents or having been qualified as Section 3 eligible residents within three years of date of first employment with the business.
List of all current full-time employees, and
List of employees claiming Section 3 status and for each such employee:
PHA/IHA Residential lease less than three years from date of employment, or
Other evidence of Section 3 status less than three years from day of employment.
I certify that the above information is correct.
Signature
Type Name and Title
Date
Note: The local government shall maintain this form and supporting documentation in the CDBG project files for review during monitoring.
File details come from the government source that posted it. Updated .