SBE_Compliance_Form.pdf
PDF 102 KB Posted
- Attached to
- County-Wide Roofing Replacement and Repair
- Solicitation number
- 25-0354-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, designed to track subcontractor information and compliance with mandatory small business participation goals. The form provides space for the prime contractor to list multiple subcontractors, including their company names, addresses, contact information, and the dollar amount of subcontracted work. The prime contractor must certify the accuracy of the information, and the form will become part of the contract with Pinellas County.
The form includes a section for Pinellas County's Purchasing Staff to review and determine whether the bidder meets the Invitation to Bid's SBE goals. While specific percentage goals are not filled in on this template, the form is structured to ensure transparency and accountability in subcontractor selection and participation. The document requires the authorized representative's signature, affirming the completeness and truthfulness of the submitted information, and provides space for county staff to initial and date their compliance review.
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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 .