Appendix 1~6.docx

COMMITMENT TO DIVERSITY GUIDANCE

Section I – Instructions

Please read this entire form and provide the requested information as applicable and per the instructions. Only the prime vendor’s commitment to diversity will be evaluated. All signature areas contained in this form and requested attachments should be completed in full and submitted with the technical response (Packet 1).

Section II – Commitment to Diversity Category Selection

Category I (N/A) Full points will be awarded if the Offeror submits a Utilization Plan meeting this solicitation’s goal 100% through self-performance. Half points will be awarded if the Offeror submits a Utilization Plan meeting this solicitation’s goal by subcontracting or demonstrating a commitment constituting a good faith effort. No points will be awarded if the Utilization Plan doesn’t meet this solicitations’ goal or demonstrate a commitment constituting good faith effort.

· Offeror submitted a Utilization Plan meeting this solicitation’s goal 100% through self-performance.

· Offeror submitted a Utilization Plan meeting this solicitation’s goal by subcontracting or demonstrating a commitment constituting a good faith effort.

· Offeror did not submit a Utilization Plan meeting this solicitation’s goal nor submit a Utilization Plan demonstrating a commitment constituting a good faith effort.

Category II (20) Identify an event(s) where you assisted businesses owned by women, minorities, or persons with disabilities, and provide a description of the nature of assistance. The assisted business is not required to be certified in the Illinois Business Enterprise Program. Examples include but are not limited to the following: assisting with obtaining lines of credit, insurance, necessary equipment, supplies, materials, or related assistance or services.

The success or failure of each event does not impact the points achieved.

Identify who was assisted Click here to enter text.

Identify the date and nature of assistance.

Click here to enter text.

If applicable, identify the bank, insurance broker, etc. involved in the transaction (if applicable).

Click here to enter text.

Category III (20 points available) Provide a copy of your written supplier diversity program.

· Offeror did not attach its written supplier diversity program to this form, or the attached form did not include a supplier diversity program.

· Offeror’s written supplier diversity program includes the usage of diverse vendors in the supply chain.

Category IV (20 points available) Provide a copy of your written training or mentoring program for businesses owned by women, minorities, or persons with disabilities.

· Offeror did not attach its written training or mentoring program for businesses owned by women, minorities, or persons with disabilities or the attached form did not include training or mentoring programs for women, minorities, or persons with disabilities.

· Offeror’s written training or mentoring program includes businesses owned by women, minorities, or persons with disabilities.

Category V (41 points available) Provide the following information. All lines should be completed even if the answer is “N/A” for not applicable.

Points for this category are calculated using this formula: Total Leadership Percentage (Sum1b +2b +3b)/Sum (1a, 2a,3a) X Total Points Available for Category IV = Points Scored for Category IV.

Section III – Signature

The undersigned certifies that the statements set forth in this document are true and correct, except as to matters therein stated to be on information and belief and as to such matters the undersigned certifies as aforesaid that he or she verily believes the same to be true.

(AMW081821) 2