SBE_Compliance_Form.pdf
PDF 102 KB Posted
- Attached to
- FY 2025 - Pavement Preservation - Package 4
- Solicitation number
- 25-0669-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
The document is a Small Business Enterprise (SBE) Compliance Form for Pinellas County, Florida, specifically related to the FY 2025 Pavement Preservation - Package 4 project. The form is designed to track subcontractor information and ensure compliance with mandatory SBE project goals for a roadway improvement initiative that includes four paving locations comprising approximately 34.98 lane miles, including two arterial roads and two local neighborhood projects.
The compliance form requires prime contractors 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 is true and complete, and 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 SBE goals outlined in the Invitation to Bid.
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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 .