Copy of sdp-rplan-form-3-reporting~8.xlsx

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Attached to
DRM 2018-46 #4 Conduit Installation @ Bridgewater State Hospital
Solicitation number
BD-22-1025-DOCFS-9832-67440
Issued by
Plymouth County, Boston City, Massachusetts

About this file

The document provided is a Supplier Diversity Program (SDP) Spending Report Form required to be completed and submitted by a contractor to the Commonwealth of Massachusetts within 45 days of the end of each quarter. The form includes information on the contractor's annual SDP spending commitment percentage, quarterly and year-to-date actual SDP spending with certified partner companies, and requires the contractor to explain any non-compliance with the annual spending commitment. The related state and local contract opportunity is for a project to install conduit at Bridgewater State Hospital, with plans and specifications available on October 14, 2021 and bid intent forms due by October 22, 2021 at 12:00 PM to the Department of Correction's Division of Resource Management.

The SDP Spending Report Form requires the contractor to provide details on their SDP partner companies, including the partner's name, email address, certification type, and quarterly spending amounts. The contractor must certify under pains and penalties of perjury that the information provided in the report is accurate. The Commonwealth reserves the right to contact SDP partners to verify the amounts reported as paid to them by the contractor.

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Other files

File Type Posted
Plan Holders List Final.docx DOCX document
DRM 2018-46 4 Bridgewater Conduit Addendum No. 1.pdf PDF
DRM 2018-46 4_ Bid Package.doc DOC document
Bid Results~42.doc DOC document
DRM 2018-46 4_ Bid Intent Form.doc.rtf RTF text file
Site Visit Attendees~7.docx DOCX document
Prevailing Wage Statement of Compliance~39.pdf PDF
Bidder Checklist~30.doc DOC document
Prevailing Wages~14.pdf PDF
Where to get plans and specs~20.docx DOCX document
Prevailing Wage Payroll Report Form~39.pdf PDF
Show all 11

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Text version

SDP Spending Report

Supplier Diversity Program (SDP) Spending Report
SDP Plan Form #3
Document Number/Name:
Instructions: This form must include information on your company's spending with your Supplier Diversity Program (SDP) Partner(s) and must be completed and submitted
within 45 days of the end of each quarter to Commonwealth Contract Manager.

Part I Contractor Information (Required)

Contractor CompanyContact NameAnnual Supplier DiversityQuarterly Contract SalesFiscal Year
NameSpending Commitment %*Quarter 1 (7/1-9/30)Quarter 2 (10/1-12/31)Quarter 3 (1/1-3/31)Quarter 4 (4/1-6/30)Total (calculates automatically)
$ - 0

Part II SDP Partner Information (Required) (Insert additional lines as needed)

SDP Partner(s) CompanyEmail Address**Certification Type***Quarterly Spending with Supplier Diversity Partner(s)Fiscal Year
Name (as it appears on a list at www.mass.gov/sdo)(Choose One)Quarter 1 (7/1-9/30)Quarter 2 (10/1-12/31)Quarter 3 (1/1-3/31)Quarter 4 (4/1-6/30)Total (calculates automatically)
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
$ - 0
Year-To-Date Compliance Check (Do not change this line)$ - 0

If not in compliance, please explain why and what actions will be taken to bring your company to compliance with the annual spending commitment:

Part III Under the pains and penalties of perjury I certify that the information provided in this report is accurate.

NameSupplier Diversity Certification Acronyms:
TitleMBE - Minority Business Enterprise
PhoneWBE - Woman Business Enterprise
EmailM/WBE - Minority and Woman Business Enterprise
Authorized SignatureSDVOBE - Service-Disabled Veteran-Owned Business Enterprise
(May be left blank if submitted electronically)VBE - Veteran-Owned Business Enterprise
DateM/NPO - Minority Non-Profit Organization
W/NPO - Women Non-Profit Organization
*This is your company's SDP Plan commitment percentage submitted in your Bid ResponseM/W/NPO - Minority and Women Non-Profit Organization
or established through negotiation.DOBE - Disability-Owned Business Enterprise
**The Supplier Diversity Office and contracting department reserves the right to contactLGBTBE - Lesbian, Gay, Bisexual or Transgender Business Enterprise
SDP Partners at any time to request that they attest to the amounts reported to have been
paid to them by the Contractor.
***Certification Type for SDP Partner(s) can be checked at www.mass.gov/sdoRevised: March 8, 2016

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