SBE_FORM23-1234.pdf
PDF 154 KB Posted
- Solicitation number
- 23-1234-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 designed for a contract opportunity related to the Stormwater Starkey Facility M10 Modification project. The form is structured to capture subcontractor information and verify compliance with mandatory Small Business Enterprise project goals, which are set at 11% for this procurement. The form provides spaces for prime contractors to list multiple subcontractors, including their company names, addresses, contact information, and the dollar amount of subcontracted work.
The form requires certification from the authorized representative that the information provided is true and complete, with an understanding that the compliance 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. This particular compliance form is part of a broader procurement process for a stormwater management facility improvement project funded through multiple sources including the Penny for Pinellas, Southwest Florida Water Management District (SWFWMD), and American Rescue Plan Act (ARPA) funds.
View the file
Other files
Show all 23
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .