SBE_Compliance_Form.pdf
PDF 160 KB Posted
- Attached to
- FY 2026 Pavement Preservation Package 2-STEP 2
- Solicitation number
- 25-0071-ITB-C STEP 2
- 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 small business participation goals for a county procurement opportunity. The form provides space for the prime contractor to list multiple subcontractors, including their company names, addresses, contact information, and the amount of subcontracted work. The prime contractor must certify the accuracy of the information and acknowledge that this form will become part of their contract with Pinellas County.
The form includes a section for Pinellas County purchasing staff to review and determine whether the bidder meets the mandatory SBE project goal percentage specified in the special conditions section. The county staff will mark whether the bidder is or is not in compliance with the Invitation to Bid SBE goals. The form requires signatures from the authorized representative of the prime contractor and allows for review and notation by the county's purchasing staff, serving as a mechanism to ensure small business participation in the county's procurement process.
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Text version
APPENDIX 7 - SBE COMPLIANCE FORM
APPENDIX 7 – SBE COMPLIANCE FORM
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:
MANDATORY SBE PROJECT GOAL PERCENTAGE LISTED IN SPECIAL CONDITIONS SECTION
File details come from the government source that posted it. Updated .