SBE_Compliance_Form.pdf

PDF 102 KB Posted

Attached to
HVAC PM, Repairs and Replacement
Solicitation number
24-0365-ITB-C
Issued by
Pinellas County, Florida

About this file

The document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, specifically related to an HVAC maintenance and replacement contract opportunity. The form is designed to capture subcontractor information and ensure compliance with mandatory Small Business Enterprise project goals. It provides space for prime contractors to list subcontractors, including company names, addresses, contact information, and the amount of subcontracted work.

The form requires the prime contractor to certify the completeness and accuracy of the submitted information, with the understanding that this 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 Invitation to Bid SBE goals. This document is a critical component of the procurement process for the HVAC preventative maintenance, repair, and replacement contract, ensuring opportunities for small businesses and transparent subcontracting practices.

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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 .