SBE_Compliance_Form.pdf
PDF 104 KB Posted
- Solicitation number
- 26-0394-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is an SBE Compliance Form used by Pinellas County, Florida, for evaluating bidder compliance with Small Business Enterprise (SBE) participation goals on contract opportunities. The form requires prime contractors to disclose all subcontractors involved in the project, including company names, addresses, contact information, email, telephone numbers, and the dollar amount of subcontracted work. The form includes space for multiple subcontractors and requires certification that all information provided is true and complete. Purchasing staff members review the completed form to determine whether bidders meet the mandatory SBE project goals established in the invitation to bid.
The form serves as a compliance verification tool and becomes part of the executed contract with Pinellas County. Authorized representatives must sign and date the form, and purchasing staff must initial and date their compliance determination. The form does not specify particular SBE goal percentages, pricing terms, or contract award dates, as these details are referenced in the related invitation to bid documentation. This particular form is associated with the Solid Waste Administration Building HVAC Renovation project in Florida, which involves complete replacement of building HVAC systems, including demolition and installation of new equipment, controls, and ductwork modifications.
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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: |
File details come from the government source that posted it. Updated .