SBE_Compliance_Form.pdf
PDF 102 KB Posted
- Solicitation number
- 25-0742-ITB-C STEP 1
- Issued by
- Pinellas County, Florida
About this file
The document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, Florida, specifically related to the Cured-In-Place Pipe (CIPP) Stormwater Pipe Rehabilitation project. The form is designed to track subcontractor information and ensure compliance with mandatory Small Business Enterprise project goals. It provides spaces for the prime contractor to list subcontractors, including company names, addresses, contact information, and the amount of subcontracted work.
The form requires the prime contractor to certify the accuracy of the information provided 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. The form is part of the county's effort to promote small business participation in public works projects, specifically for the stormwater pipe rehabilitation initiative, which aims to improve and maintain critical infrastructure through innovative pipe rehabilitation techniques like Cured-In-Place Pipelining (CIPP).
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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 .