SBE_Compliance_Form.pdf
PDF 102 KB Posted
- Attached to
- FY2026 Pavement Preservation Package 4
- Solicitation number
- 25-0634-ITB-C
- Issued by
- Pinellas County, Florida
About this file
The document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, Florida, specifically related to the FY2026 Pavement Preservation Package 4 project. The form is designed to track subcontractor information and ensure compliance with mandatory Small Business Enterprise project goals for a roadway improvement initiative. The project encompasses five paving locations, including one arterial and four local neighborhood projects, totaling approximately 29.54 lane miles of roadway.
The compliance form requires prime contractors to list subcontractor details, including company names, addresses, contact information, and the amount of subcontracted work. The form includes a certification statement where the authorized representative affirms the accuracy of the provided information and acknowledges that the form will become part of the contract with Pinellas County. A section is reserved for Pinellas County Purchasing Staff to review and confirm whether the bidder meets the Invitation to Bid SBE goals, allowing them to mark compliance status and record their review.
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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:
File details come from the government source that posted it. Updated .