B2627323 LGBTQ Applicant Data Form.pdf
PDF 2 MB Posted
- Attached to
- CCOM Storage Racks
- Solicitation number
- B2627323
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Opportunity Data Form for the City of Philadelphia related to contract opportunity B2627323 for CCOM Storage Racks. The form is designed to collect voluntary demographic information from applicants regarding beneficial ownership and control by Lesbian, Gay, Bisexual, Transgender, and Queer persons. The form requests applicants to identify whether their business is beneficially owned and controlled by LGBTQ individuals and whether they hold current LGBTBE certification through the National LGBT Chamber of Commerce (NGLCC) via its Philadelphia affiliate, the Independence Business Alliance (IBA). Additionally, applicants must disclose any additional third-party certifications from agencies such as the Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN, or Women's Business Enterprise National Council (WBENC), along with their respective certification categories. The form also requires disclosure of any NGLCC/IBA-certified subcontractors involved in the contract performance.
The City of Philadelphia utilizes this data collection as part of its commitment to diversity, equity, and inclusion in procurement activities to identify the number of LGBTQ businesses currently conducting business with the City and to facilitate the inclusion of LGBTQ-certified businesses in the City's vendor database. The micro purchase for CCOM Storage Racks will be awarded as a whole or by line item, whichever serves the City's best interest, to the lowest responsive and responsible bidder. Applicants must quote all items to be eligible for award, and no delivery or services should commence until notification is received from the contracting department. Response to the data collection form is voluntary and does not affect bid eligibility or award decisions.
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Text version
LGBTQ Applicant Opportunity Data
1. Is Applicant’s business beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender or Queer?
2. Is Applicant’s business currently certified as a Lesbian, Gay, Bisexual, Transgender, Business Enterprise (LGBTBE) by the National LGBT Chamber of Commerce (NGLCC) through their local Philadelphia affiliate, the Independence Business Alliance (IBA)?
a. If yes, Applicant is currently certified by NGLCC/IBA as an LGBTBE, is Applicant's business also certified by any other third party certifying agency such as Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN or Women's Business Enterprise National Council (WBENC)?
If yes please identify the name of the certifying agency and category of certification (e.g., MBE, WBE, DSBE, DBE):
Certifying Agency Certification Category
3. For this contracting opportunity, are any of Applicant’s subcontractors certified by NGLCC/IBA? If yes, how many subcontractors are certified as LGBTBE?
Please list all by business name below.
As part of the City’s commitment to diversity, equity and inclusion in all aspects of City procurement, the City is collecting data to identify the number of companies beneficially owned and controlled by Lesbian, Gay, Bisexual, Transgender and Queer persons who wish to do business with the City (collectively, “LGBTQ businesses”). The data will be used to identify the number of LGBTQ businesses currently doing business with the City. It will also assist in efforts to include LGBTQ certified businesses into the City’s vendor database. Response to this form is voluntary.
Applicant Name
Bid or Opportunity #
| CertifiedLGBTEYes: Y |
| CertifiedLGBTENo: N |
| Certification: |
| LGBTQTypeYes: Y |
| LGBTQTypeNo: N |
| CertifiedNGLCCNo: N |
| CertifiedNGLCCYes: Y |
| LGBTQTypeY: Off |
| LGBTQTypeN: Off |
| CertifiedLGBTEY: Off |
| CertifiedLGBTEN: Off |
| CertifiedNGLCCY: Off |
| CertifiedNGLCCN: Off |
| Subconsultants: |
| BusinessName3: |
| BusinessName4: |
| BusinessName5: |
| Reset: |
| btnContinue: |
| CertifyingAgency: |
| BusinessName: |
| BusinessName2: |
| ApplicantName: |
| BidNumber: |
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