SBE_Compliance_Form.pdf
PDF 160 KB Posted
- Attached to
- FY25 Pavement Preservation Package No 2
- Solicitation number
- 24-0756-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
The document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, Florida, specifically related to the FY25 Pavement Preservation Package No. 2 project. The form is designed to capture subcontractor information and ensure compliance with the county's small business participation goals for the roadway improvement project, which involves milling and resurfacing approximately 34.65 lane miles across four different locations, including one collector and three local neighborhood projects.
The compliance form requires the prime contractor to list detailed information about subcontractors, including company names, addresses, contact information, and the dollar amount of subcontracted work. The form includes a certification by the authorized representative that the information provided is true and complete, and it will become part of the contract with Pinellas County. The county's purchasing staff will review the form to determine whether the bidder meets the mandatory SBE project goal percentage specified in the special conditions section of the bid documents.
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Text version
APPENDIX 7 - SBE COMPLIANCE FORM
APPENDIX 7 – SBE COMPLIANCE FORM
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:
MANDATORY SBE PROJECT GOAL PERCENTAGE LISTED IN SPECIAL CONDITIONS SECTION
File details come from the government source that posted it. Updated .