SBE_Compliance_Form.pdf
PDF 104 KB Posted
- Attached to
- STAR Center AHU -104, -161, -162 Replacement
- Solicitation number
- 26-0306-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is an SBE Compliance Form for Pinellas County, Florida's Invitation to Bid for Construction (ITB-C #26-0306) regarding the replacement of air handling units at the Young-Rainey STAR Center. The form requires prime contractors and their subcontractors to document participation commitments to meet mandatory Small Business Enterprise (SBE) project goals. Bidders must submit completed compliance documentation identifying all subcontractors, their business addresses, contact information, and the dollar amounts of subcontracted work. The form serves as a binding certification that submitted information is true and complete, and upon execution, becomes part of the contract with Pinellas County. Purchasing staff review and verify bidder compliance with established SBE goals prior to contract award, with the form indicating whether bidders meet or fail to meet the participation requirements.
The SBE Compliance Form establishes that Pinellas County has set a Small Business Enterprise participation goal of 3 percent of the contract value, with qualified subcontractors required to be selected from Pinellas, Hillsborough, Pasco, or Manatee Counties. Submission of this form is mandatory for all bidders responding to the invitation, and the authorized representative's signature certifies the accuracy of all subcontracting commitments disclosed. The form becomes a permanent component of the executed contract, making SBE participation commitments binding and enforceable throughout the project performance period.
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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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