SBE_Compliance_Form.pdf
PDF 102 KB Posted
- Attached to
- Pump Station 182 Rehabilitation (PID 005221A)
- Solicitation number
- 25-0422-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is an SBE (Small Business Enterprise) Compliance Form used by Pinellas County for contract procurements that require mandatory small business participation goals. The form serves as a template for prime contractors to document their subcontractor commitments and demonstrate compliance with the county's SBE requirements for invitation to bid processes. The document provides spaces for recording the prime contractor name, mandatory SBE project goals percentage, and detailed information for up to four subcontractors including company names, addresses, contact information, and the dollar amounts of subcontracted work.
The form includes a certification statement where the authorized representative must attest that the information provided is true and complete, with the understanding that the compliance form becomes part of the contract with Pinellas County. A section designated for county use only allows purchasing staff to review and determine whether the bidder is in compliance with the invitation to bid SBE goals, requiring staff initials and date confirmation. The form emphasizes the mandatory nature of SBE participation requirements and serves as both a planning tool for contractors and a verification mechanism for the county to ensure small business inclusion goals are met in public contracting opportunities.
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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 .