SBE_FORM.pdf
PDF 332 KB Posted
- Solicitation number
- 24-0073-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 Sanitary Sewer Pump Station Repair, Rehabilitation, and Improvement Contract for Fiscal Years 2025-2028. The form is designed to document subcontractor information and demonstrate compliance with mandatory Small Business Enterprise project goals, which are set at 10% for this contract. The form provides space for listing multiple subcontractors, including their company names, addresses, contact information, and the amount of subcontracted work.
The compliance form requires the prime contractor to certify the accuracy of the submitted information 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 confirm whether the bidder meets the Invitation to Bid SBE goals. By completing this form, contractors demonstrate their commitment to utilizing small businesses as subcontractors and supporting local economic development objectives within the public works 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:
File details come from the government source that posted it. Updated .