SBE_FORM.pdf

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Attached to
FY 2024 Pavement Preservation Package 1
Solicitation number
23-0831-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 FY 2024 Pavement Preservation Package 1 project. The form is designed to track subcontractor information and ensure compliance with mandatory Small Business Enterprise project goals, which are set at 7% for this contract. The form provides space for prime contractors to list subcontractors, including company names, addresses, contact information, and the amount of subcontracted work.

The compliance form requires the prime contractor to certify the accuracy of the information provided 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 meets the SBE goals outlined in the Invitation to Bid. The form is a critical component of the county's efforts to promote small business participation in public contracts, specifically for the pavement preservation project that involves milling and resurfacing approximately 25 miles of roadway across four different locations.

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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 .