SBE_FORM.pdf
PDF 332 KB Posted
- Solicitation number
- 24-0309-ITB-C
- Issued by
- Pinellas County, Florida
About this file
This document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, Florida, specifically related to the Aboveground Fuel Site Closures project funded by ARPA and other grants. The form is designed to document subcontractor information and compliance with mandatory SBE project goals for a contract involving the closure of aboveground storage tank (AST) fueling systems at two locations: Walsingham Park in Largo and Mosquito Control in Clearwater. Each site features a 6,000-gallon UL 2085 Fireguard double-walled dual section tank with separate capacities for unleaded gasoline and low sulfur diesel fuel.
The compliance form provides a template for prime contractors to list subcontractors, including company details, contact information, and the amount of subcontracted work. The form requires certification from the authorized representative that the information is true and complete, and it will become part of the contract with Pinellas County. The county's purchasing staff will review the form to determine compliance with the Invitation to Bid SBE goals. While specific financial details are not filled out in this template, the form indicates a structured approach to ensuring small business participation in the fuel site closure project.
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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:
N/A
File details come from the government source that posted it. Updated .