SBE_Compliance_Form.pdf
PDF 102 KB Posted
- Attached to
- FY 2024 Pavement Preservation Package 2
- Solicitation number
- 23-0832-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 FY 2024 Pavement Preservation Package 2 project. The form is designed to track subcontractor information and ensure compliance with mandatory Small Business Enterprise project goals. It provides a template for prime contractors to list subcontractors, including their company names, addresses, contact information, and the amount of subcontracted work.
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 determine whether the bidder meets the Invitation to Bid SBE goals. While the specific SBE percentage goal is not filled in on this template, the form is a critical component of the procurement process for the pavement preservation project, which involves milling and resurfacing approximately 31.2 miles of roadway across four locations, including one arterial and three neighborhood projects.
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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 .