SBE_Compliance_Form.pdf
PDF 104 KB Posted
- Attached to
- Palm Harbor Recreation Center Addition State and local contract opportunity
- Solicitation number
- 26-0011-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
SBE Compliance Form Summary
This is an SBE Compliance Form for Pinellas County related to the Palm Harbor Recreation Center Addition project in Florida. The form is used to document prime contractor and subcontractor information for projects subject to Small Business Enterprise participation goals. Bidders are required to submit this form identifying all proposed subcontractors, including company names, addresses, contact information, and the dollar amount of subcontracted work for each firm. The form includes certification language whereby the prime contractor attests to the accuracy and completeness of the submitted information. Pinellas County Purchasing Staff are designated to review the form and determine whether the bidder meets the established SBE goals for the project. The Palm Harbor Recreation Center Addition project, a 28,000 square foot recreation center construction project with a 425 consecutive calendar day contract term from Notice to Proceed, has established a 15 percent SBE participation goal for subcontractors, with Step 1 bid submissions due November 11, 2025, and Step 2 submissions due November 20, 2025.
The SBE Compliance Form requires bidders to demonstrate how they will meet or exceed the 15 percent small business enterprise participation threshold through documented subcontractor commitments. Pinellas County's purchasing staff will verify compliance with the stated SBE goals and document their findings on the form. The form becomes part of the executed contract with Pinellas County, binding both the prime contractor and identified subcontractors to the commitments made in the submission. Failure to meet documented SBE participation goals may result in a determination of non-compliance and potential rejection of the bid.
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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:
| COMPANY: |
| COMPANY_2: |
| ADDRESS 1: |
| ADDRESS 2: |
| ADDRESS 1_2: |
| ADDRESS 2_2: |
| undefined_2: |
| undefined_3: |
| CONTACT 1: |
| CONTACT 2: |
| CONTACT 1_2: |
| CONTACT 2_2: |
| TELEPHONE: |
| COMPANY 1: |
| COMPANY 2: |
| COMPANY 1_2: |
| COMPANY 2_2: |
| ADDRESS: |
| ADDRESS_2: |
| undefined_4: |
| undefined_5: |
| CONTACT 1_3: |
| CONTACT 2_3: |
| CONTACT 1_4: |
| CONTACT 2_4: |
| TELEPHONE_2: |
| TELEPHONE_3: |
| undefined_6: |
| I have reviewed this Compliance Form and found the Bidder: Off |
| IS: Off |
| Initials: |
| Date: |
| Name: |
| Project Goals: |
| Contractor Name: |
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