SBE_FORM.pdf
PDF 332 KB Posted
- Solicitation number
- 23-0653-ITB-C STEP 2
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, designed to track subcontractor information and meet mandatory project goals for small business participation. The form provides space for listing multiple subcontractors, including their company names, addresses, contact information, and the amount of subcontracted work. The form requires the prime contractor to certify the accuracy of the information and understand that this document will become part of the contract with Pinellas County.
The form includes a section for Pinellas County's purchasing staff to review and determine whether the bidder is in compliance with the Invitation to Bid SBE goals. While the specific SBE percentage goal is left blank in this template, the form is structured to support the county's efforts to promote small business participation in county contracts. The document serves as a critical tool for tracking and ensuring small business involvement in county procurement processes, with space for an authorized representative's signature and certification of the provided information.
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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 .