24-0082_Attachment D Commitment to Diversity Vendor Answer Sheet Traffic Incident Management System_TIMS_.pdf

I. BEP Goal Compliance:

Have you met the set goal for contracting or subcontracting with businesses owned by women, minorities, or persons with disabilities or completed a Good Faith Efforts Waiver for this procurement? If there is no BEP goal the 5 points will automatically be awarded. ☐ BEP Goal Met

☐ Good Faith Efforts Waiver ☐ Self-fulfilling ☐ No BEP Goal on Procurement

Verification:

☐ List of vendors and % goal met ☐ U-Plan ☐ Copy of Good Faith Efforts Waiver

II. Subcontracting / Contracting with any WMDB (not Limited to BEP) Outside of Current Solicitation:

Please list any WMD (women, minorities, or persons with disabilities) businesses that your business has contracted / subcontracted within the prior calendar year. Businesses are not required to be registered with the Illinois Business Enterprise Program.

*Subcontracts listed in UPlan for this procurement do not qualify for this factor

Contract Purpose

Vendor Type of Diversity

Address Phone/Email Length of Contract

Cost Percentage from overall spend

Verification ☐ Attached list, if not identified in the table ☐ Attached contracts

Vendor:

Date:

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COMMITMENT TO DIVERSITY VENDOR ANSWER SHEET

Bid # -

III. DEI Spend Percentage of business, education and/or community spend from prior calendar year gross revenue that involves businesses owned by women, minorities and/or persons with disabilities. The assisted business is not required to be certified in the Illinois Business Enterprise Program.

Item Percent Amount Description

Verification:

☐Attached list, if not identified in the table ☐Attached receipts ☐Attached loan contracts ☐Attached purchase description ☐Attached fundraiser flyer ☐Attached references ☐Other________________ ☐Other________________ ☐Other________________

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IV. DEI Time:

Hours spent in the prior calendar year on promoting DEI in the workplace, the community, education institutes, or supporting businesses owned by women, minorities, or persons with disabilities. The assisted business is not required to be certified in the Illinois Business Enterprise Program. The success or failure of each event does not impact the points achieved.

Verification: ☐Attached list, if not identified in the table ☐Attached references ☐Attached event emails/pages ☐Attached event flyer ☐Other________________

V. DEI Policies Vendor has provided a written copy of, or screenshot of, their current written workforce diversity, equity, and inclusion (“DEI”) policy.

☐Yes we have actionable DEI Policies ☐No we do not have actionable DEI Policies

Verification:

Activity Date Hours Description

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☐Screenshot of policies on website ☐Attached policies

VI. Diversity in Staffing

• % of individuals on governing board and/ or senior executives who identify as women, minorities or person with disabilities.

• % of individuals in management /supervisor positions who identify as women, minorities or person with disabilities.

• % of total staff who identify as women, minorities or person with disabilities.

Round up to next whole percent. Ex: .045%= 1%

Role Number of WMD Staff

Percentage of WMD Staff

Types of Diversity Number of Total

Staff Staff

Governing Board/Executive

Management/Supervisor

Verification:

☐Attached staff list including role and diversity type

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This disclosure is signed by an authorized officer or employee on behalf of the submitting Vendor/Offeror.

The undersigned certifies and affirms that the statements set forth in this document are true and accurate.

Name of Disclosing Entity:___________________________________

Signature:_________________________________________________ Date:___________________

Printed Name:______________________________________________________________________

Title:________________________________________________________________

Phone Number:_______________________________________________________

Email Address:________________________________________________________

Verification Checklist Documents must be uploaded with the bid as its own “Required Quote Attachment” labeled as “Commitment to Diversity” along with the Vendor’s technical and pricing bids. Documents must be uploaded as either a zip file or PDF portfolio with each document labeled to identify what it is or is in support of.

*** IF A VERFICATION DOCUMENTIS NOT ATTACHED POINTS WILL NOT BE REWARDED***

Verification Attached Page #/section (if available)

List of vendors and % goal met U-Plan Copy of Good Faith Efforts Waiver List of contracts/subcontracts with contract purpose, vendor name, diversity type, address, contact, cost, length, percentage from total spend Copy of signed contracts List of spend items, amount, percent, and description Receipts Loan contracts Money spent references List of activities, dates, hours, and descriptions Time spent list Time spent references Event emails/pages Flyers from events/fundraisers Screenshot of DEI policies on website DEI policies Staffing list with roles and diversity types Other:

Other:

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