SBE_Compliance_Form.pdf
PDF 104 KB Posted
- Solicitation number
- 26-0363-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is an SBE Compliance Form prepared by Pinellas County, Florida, for use in evaluating bidder compliance with Small Business Enterprise (SBE) participation goals on the Fiscal Year 2027 Pavement Preservation Package 3 project. The form requires prime contractors to identify mandatory SBE project goals as a percentage and list all subcontractors engaged on the project, including company names, addresses, contact information, email addresses, telephone numbers, and the dollar amount of subcontracted work. The form includes certification language requiring the prime contractor to attest under penalty that all information provided is true and complete to the best of their knowledge and belief, with the understanding that the completed form becomes part of the contract with Pinellas County.
The form provides space for Pinellas County purchasing staff to review bidder compliance with stated SBE goals and mark whether the bidder IS or IS NOT in compliance with the Invitation to Bid requirements. An authorized representative of Pinellas County must sign and date the form after completing the compliance review. The form structure allows documentation of multiple subcontractors across several line items, enabling comprehensive tracking of SBE participation throughout the project delivery.
View the file
Other files
Show all 25
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .