SBE_FORM.pdf

PDF 114 KB Posted

Attached to
WTE Structural Steel Replacement
Solicitation number
23-1161-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, specifically related to the Waste-to-Energy (WTE) Structural Steel Replacement project. The form is designed to track subcontractor information and demonstrate compliance with mandatory Small Business Enterprise project goals, which are set at 5% for this contract. The form provides space for prime contractors to list subcontractor details, including company names, addresses, contact information, and the amount of subcontracted work.

The form requires the prime contractor to certify the accuracy of the information provided and acknowledges that the completed form will become part of the contract with Pinellas County. A section is reserved for Pinellas County purchasing staff to review and confirm compliance with the Invitation to Bid SBE goals. The document is part of the procurement process for the WTE Facility structural steel replacement project, which aims to address structural degradation due to long-term weather exposure and improve working conditions and component longevity.

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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 .