SBE_FORM.pdf
PDF 332 KB Posted
- Attached to
- FY 2024 Pavement Preservation Package 3
- Solicitation number
- 23-0833-ITB-C
- Issued by
- Pinellas County, Florida
About this file
The document is an SBE (Small Business Enterprise) Compliance Form for Pinellas County, Florida, specifically related to the FY 2024 Pavement Preservation Package 3 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 particular 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 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 determine whether the bidder meets the SBE goals outlined in the Invitation to Bid. The form is a critical component of the county's commitment to supporting small businesses and ensuring diverse participation in public works projects, in this case, a pavement preservation initiative involving approximately 36.05 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 .