Appendix 4 NIGP Code Revision Request Form.pdf

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Attached to
Open Market Competitive Sealed Proposal IL|24-416CMS-BENF4-P-77070
Contract number
24-416CMS-BENF4-P-77070
Issued by
Illinois

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The document is a NIGP (National Institute of Governmental Purchasing) Code Revision Request Form issued by the Illinois Commission on Equity and Inclusion. It is a standardized form designed for vendors participating in state procurement processes, specifically related to the Business Enterprise Program (BEP) and Veteran Business Program (VBP) certifications.

The form provides a mechanism for vendors to request revisions to NIGP codes in a solicitation, requiring vendors without BEP or VBP certifications to use certified subcontractors registered in the solicitation's specified NIGP codes. The form includes sections for vendors to provide justification for code revisions, list current and requested NIGP codes, and obtain approval from the purchasing entity. It emphasizes compliance with CEI Notice 2023.3, which mandates that prime vendors either use certified subcontractors or obtain prior approval for code variations before the bid opening date.

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Illinois Commission on Equity and Inclusion NIGP Code Revision Request Form

NIGP Code Revision Request Form V.23.1 Page 1 of 2

Per CEI Notice 2023.3, prime vendors without Business Enterprise Program (BEP) or Veteran Business Program (VBP) certifications must use certified BEP and/or VBP subcontractors registered in the solicitation's NIGP codes unless they obtain revision approval from the purchasing entity before the bid opening date. Self-performing certified BEP/VBP prime vendors must be registered in all of the solicitation’s NIGP codes unless they obtain revision approval from the purchasing entity before the bid opening date.

Section I – General Information (to be completed by the requesting vendor)

Vendor Name:

Purchasing Entity:

Bulletin Reference Number:

Solicitation Title:

Solicitation Description:

Current BEP Goal Percentage:

Current VBP Goal Percentage:

Section II – Vendor Justification (to be completed by the requesting vendor)

Are you certified in the BEP or VBP programs?

Select the appropriate option:

List the NIGP codes specified in the solicitation:

Which NIGP codes are you currently registered in?

Select the type of NIGP code revision:

List the NIGP Codes that should be added. If this field is not applicable, enter "N/A".

Illinois Commission on Equity and Inclusion NIGP Code Revision Request Form

NIGP Code Revision Request Form V.23.1 Page 2 of 2

List the NIGP Codes that should be removed. If this field is not applicable, enter "N/A".

Provide a justification for the requested revision(s):

Did you contact vendors in the current NIGP code pool? If yes, list the vendors below. If no, explain why.

Section III – Vendor Certification and Signature (to be completed by the requesting vendor)

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

Printed Name:

Title:

Phone Number:

Email Address:

Vendor Signature:

Date:

Note: Submit the completed form to the appropriate purchasing entity contact for review and processing.

Section IV – Purchasing Entity Determination (to be completed by the purchasing entity’s procurement officer)

☐ I approve this request.

☐ I do not approve this request.

Comments:

Printed Name:

Email Address:

Purchasing Entity Signature:

Date:

Bulletin Reference Number:
Current BEP Goal Percentage:
Current VBP Goal Percentage:
List the NIGP codes specified in the solicitation:
Which NIGP codes are you currently registered in:
List the NIGP Codes that should be added:
List the NIGP Codes that should be removed:
Provide a justification for the requested revisions:
Did you contact vendors in the current NIGP code pool:
Comments:
Solicitation Title:
Vendor Name:
Solicitation Description:
Printed Name:
Title:
Phone Number:
Email Address:
Purchasing Entity Printed Name:
Purchasing Entity Email Address:
Check Box 1: Off
Check Box 2: Off
Vendor Certification Dropdown: [Select an item from the list.]
Vendor Type Dropdown: [Select an item from the list.]
Revision Type Dropdown: [Select an item from the list.]
Vendor Signature Date_es_:signer:date:
Purchasing Entity Signature Date_es_:signer:date:
Purchasing Entity Dropdown_es_:date: [Select an item from the list.]

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