SBE_Compliance_Form.pdf
PDF 102 KB Posted
- Solicitation number
- 25-0537-ITB-C
- Issued by
- Pinellas County, Florida
About this file
The document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, Florida, designed to track subcontractor information and ensure compliance with mandatory Small Business Enterprise project goals for a contract. The form provides space for the prime contractor to list subcontractors, including their company names, addresses, contact information, and the amount of subcontracted work. The form requires certification from the authorized representative that the information is true and complete, and will become part of the contract with Pinellas County.
The form includes a section for Pinellas County's Purchasing Staff to review and confirm whether the bidder meets the Invitation to Bid SBE goals. While specific SBE percentage goals are not filled in on this template, the form is structured to support local procurement policies that aim to provide opportunities for small businesses in county contracts. The document is specifically related to a Federal Open Channel Drainage Repair Work Order Contract, which involves constructing open channel repairs, including slope restoration, debris removal, erosion control, and related infrastructure improvements in Pinellas County, Florida.
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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 .