SBE_Compliance_Form.pdf
PDF 104 KB Posted
- Attached to
- FY2026 Airfield Pavement Rehabilitation
- Solicitation number
- 26-0722-ITB-C
- Issued by
- Pinellas County, Florida
About this file
This is an SBE Compliance Form for Pinellas County, Florida, designed to document Small Business Enterprise (SBE) participation in contract opportunities. The form requires prime contractors to identify and report all subcontractors involved in project delivery, including company names, addresses, contact information, and the dollar amount of subcontracted work. The form serves as the official documentation mechanism for verifying contractor compliance with mandatory SBE project goals established by Pinellas County for specific solicitations. Upon completion, authorized representatives must certify the accuracy of all information provided, acknowledging that the form becomes an integral part of the executed contract.
Purchasing staff are responsible for reviewing submitted compliance forms to determine whether bidders meet the established SBE participation requirements. The form includes designated spaces for identifying compliance status and documenting the review process through staff initials, dates, and authorized signatures. This compliance verification is mandatory for contract award consideration, ensuring that contractors meet SBE participation thresholds and that subcontracting commitments are transparent and enforceable throughout contract performance. The form applies to the FY2026 Airfield Pavement Rehabilitation project in Florida, which addresses repairs to distressed asphalt airfield pavements using available maintenance budget allocations.
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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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