C2D Vendor Answer Form.pdf

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Vendor Answer Sheet State of Illinois Chief Procurement Office for General Services Commitment to Diversity: Vendor Answer Form V.26.2 V20-15 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 Effort Waiver for this procurement? If there is no BEP goal the 5 points will automatically be awarded.

Verification:

II. Subcontracting/Contracting with any WMDB Please list any WMD (women, minorities, or persons with disabilities) businesses that your business has contracted/subcontracted within the prior calendar year. This is ourside of the current solicitation. Note: Businesses are not required to be registered with BEP.

Verification:

Can attach extended table if needed Service/Product Vendor Diversity Type Length of Contract Cost III. DEI Spend Percentage of business, education, and/or community spend from prior calendar year gross revenue on promoting DEI in the workplace, the community, education institutes, or supporting businesses owned by women, minorities, or persons with disabilities. Note: The assisted business is not required to be certified in BEP.

Verification:

Can attach extended table if needed Item Percent Amount Description 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 BEP. The success or failure of each event does not impact the points achieved.

Verification:

Can attach extended table if needed Activity Date Hours Description V. DEI Policies Please provide a written copy or a screenshot of your organization’s current Workforce Diversity, Equity, and Inclusion (DEI) policy for review.

Verification:

VI. Staffing Diversity Please provide the following information using the definitions below. If one person serves in multiple roles, you may count them in each applicable category.

Governing Board: Individuals legally responsible for overseeing and operating the business.

Management: Individuals who control or administer all or part of the business.

Senior Executives: CEO, COO, CFO, or anyone who leads a major business unit or function.

Supervisors: Individuals directly overseeing staff and managing day-to-day work.

Staff: Anyone permanently employed by the business.

To determine the percentage of WMD individuals:

1. Divide the number of WMD staff by the total number of staff in the same role.

2. Multiply by 100 to get the percentage.

3. Round up to the next whole percent if necessary. Ex:0.45%=1%.

Ex:10 board members, 5 are WMD, the calculation would be (5/10)X100=50% Verification:

Role # of WMD Staff % of WMD Staff Diversity Type # of Total Staff in Role Staff Governing Board/Executives Management/Supervisors Disclosure 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.

Attached 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.

Verification Attached (Yes or No) Page #/Section (if available) List of vendors and % goal met U-Plan Copy of Good Faith Effort Waiver List of contracts with contract purpose, vendor name, diversity type, address, contact, cost, length 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:

6.5.0.20190320.2.935878.932721 Vendor Answer Form