SBE_Compliance_Form.pdf
PDF 102 KB Posted
- Solicitation number
- 25-0681-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, designed to track subcontractor information and compliance with mandatory Small Business Enterprise project goals. The form provides space for the prime contractor to list multiple subcontractors, including their company names, addresses, contact information, and the amount of subcontracted work.
The form requires the prime contractor to certify the accuracy of the information and acknowledges that the completed compliance form will become part of the contract with Pinellas County. A section is reserved for Pinellas County Purchasing Staff to review and confirm whether the bidder meets the Invitation to Bid SBE goals, with checkboxes to indicate compliance status. The form includes signature lines for the authorized representative and space for the purchasing staff member to initial and date their review.
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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 .