SBE_Compliance_Form.pdf

PDF 102 KB Posted

Attached to
Cured-In-Place Pipe (CIPP) Stormwater Pipe Rehabilitation (Re-Bid)
Solicitation number
25-0742-ITB-C
Issued by
Pinellas County, Florida

About this file

The document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, Florida, specifically related to the Cured-In-Place Pipe (CIPP) Stormwater Pipe Rehabilitation project. The form is designed to track subcontractor information and ensure compliance with mandatory Small Business Enterprise project goals. It provides space for prime contractors to list subcontractors, including company names, addresses, contact information, and the amount of subcontracted work.

The form requires the prime contractor to certify the accuracy of the information provided and acknowledges that the completed form will become part of the contract with Pinellas County. A section is reserved for Pinellas County Purchasing Staff to review and determine whether the bidder meets the Invitation to Bid SBE goals. The form is a critical component of the county's procurement process, aimed at promoting participation of small businesses in public works projects and ensuring transparency in subcontractor selection and allocation of work.

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Text version

APPENDIX 7 - SBE COMPLIANCE FORM

APPENDIX 7 – SBE COMPLIANCE FORM

Mandatory SBE PROJECT GOALS: %

PRIME CONTRACTOR NAME:

SUBCONTRACTOR(S) INFORMATION:

COMPANY: COMPANY:

ADDRESS: ADDRESS:

AMOUNT OF

SUBCONTRACTED

WORK: $

AMOUNT OF

SUBCONTRACTED

WORK: $

CONTACT: CONTACT:

EMAIL: EMAIL:

TELEPHONE: TELEPHONE:

COMPANY: COMPANY:

ADDRESS: ADDRESS:

AMOUNT OF

SUBCONTRACTED

WORK: $

AMOUNT OF

SUBCONTRACTED

WORK: $

CONTACT: CONTACT:

EMAIL: EMAIL:

TELEPHONE: TELEPHONE:

I certify that the information included in this Compliance Form is true and complete to the best of my knowledge and belief. I further understand and agree that this Compliance Form shall become a part of my contract with Pinellas County.

FOR PINELLAS COUNTY USE ONLY:

I have reviewed this Compliance Form and found the Bidder IS IS NOT in compliance with the Invitation to Bid SBE goals.

Purchasing Staff Member:

Initials: Date:

Name and Title of Authorized Representative:

Signature:

File details come from the government source that posted it. Updated .