SBE_Compliance_Form.pdf
PDF 160 KB Posted
- Attached to
- ARPA Dansville Community Park (PID 006025A)
- Solicitation number
- 24-0768-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, designed to document subcontractor information and demonstrate compliance with small business participation goals for a county procurement opportunity. The form provides space for the prime contractor to list subcontractor details, including company names, addresses, contact information, and the amount of subcontracted work for each subcontractor.
The form requires the prime contractor to certify the accuracy of the submitted information and acknowledges that the compliance 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 SBE goals outlined in the Invitation to Bid. The form includes checkboxes for the purchasing staff to indicate compliance status and provides space for signatures, initials, and dating of the document by the authorized representative.
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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 .