SBE_Compliance_Form.pdf
PDF 104 KB Posted
- Attached to
- Ridgecrest YMCA Elevator Modernization
- Solicitation number
- 26-0529-ITB-C
- Issued by
- Pinellas County, Florida
About this file
This is an SBE Compliance Form for Pinellas County, Florida, related to the Ridgecrest YMCA Elevator Modernization project located at 1801 119th Street N, Largo, FL. The form documents the prime contractor's commitment to meeting Small Business Enterprise (SBE) project goals and requires disclosure of all subcontractors participating in the project. The form includes designated fields for listing multiple subcontractors with their company information, addresses, contact details, telephone numbers, email addresses, and the dollar amounts of subcontracted work. The prime contractor must certify that all information provided is true and complete to the best of their knowledge and belief, acknowledging that the compliance form becomes part of their contract with Pinellas County.
The form requires Pinellas County purchasing staff to review and verify bidder compliance with the SBE goals established in the Invitation to Bid. The reviewing staff member must document their findings by initialing and dating the form, indicating whether the bidder is in or out of compliance with the mandatory SBE project goals. An authorized county representative must also sign the form to officially validate the compliance determination. This document serves as a critical compliance mechanism to ensure that contractors meet established small business utilization requirements for the elevator modernization project.
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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 .