SBE_Compliance_Form.pdf
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- Solicitation number
- 25-0356-ITB-C
- Issued by
- Pinellas County, Florida
About this file
The document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, specifically related to the Cured-In-Place Pipe (CIPP) Stormwater Pipe Rehabilitation project. The form is designed to capture subcontractor information and ensure compliance with the county's mandatory SBE project goal percentage, which is to be listed in the Special Conditions section. The form provides space for listing multiple subcontractors, including their company names, addresses, contact information, and the amount of subcontracted work.
The compliance form requires the prime contractor to certify the accuracy of the submitted information and acknowledges that the form will become part of the contract with Pinellas County. The document includes a section for Pinellas County purchasing staff to review and determine whether the bidder is in compliance with the Invitation to Bid SBE goals. The form must be signed by an authorized representative of the prime contractor, and it serves as a mechanism for the county to track and ensure small business participation in the public works project.
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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 .