SBE_Compliance_Form.pdf
PDF 160 KB Posted
- Attached to
- FY 2026 Pavement Preservation Package 2
- Solicitation number
- 25-0071-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 the FY 2026 Pavement Preservation Package 2 project. The form is designed to capture detailed information about prime contractors and subcontractors participating in the roadway improvement project, which involves milling and resurfacing approximately 44.26 lane miles across five neighborhood locations within the county.
The compliance form requires contractors to list subcontractor information, including company names, addresses, contact details, 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. There is also a section for Pinellas County Purchasing Staff to review and confirm compliance with the Invitation to Bid's Small Business Enterprise (SBE) goals, with checkboxes to indicate whether the bidder meets the mandatory SBE project goal percentage specified in the special conditions section.
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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 .