SBE_FORM.pdf
PDF 292 KB Posted
- Attached to
- MAINTENANCE AND MINOR REPAIRS OF FIXED CONCRETE BRIDGE STRUCTURES, PEDESTRIAN BRIDGES, AND BOX CULVERTS
- Solicitation number
- 23-0811-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
The document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, specifically related to a contract for maintenance and minor repairs of fixed concrete bridge structures, pedestrian bridges, and box culverts. The form is designed to track subcontractor information and ensure compliance with mandatory Small Business Enterprise project goals, which in this case are set at 15%. The form provides space for prime contractors to list subcontractor details, 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. A section is reserved for Pinellas County Purchasing Staff to review and confirm whether the bidder meets the SBE goals outlined in the Invitation to Bid. The form includes signature lines for the authorized representative and space for the purchasing staff member to initial and date their review, indicating a formal process for verifying small business participation in the county's contracting opportunities.
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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 .