FY 25 LGBTQ_Applicant_Data_Form~64.pdf
PDF 2 MB Posted
- Attached to
- Barber Supplies
- Solicitation number
- B2626854
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form issued by the City of Philadelphia's Procurement Department in furtherance of its diversity, equity, and inclusion initiatives in public contracting. The form collects voluntary self-identification data from applicants regarding LGBTQ business ownership and certification status for purposes of identifying and tracking LGBTQ-owned businesses interested in doing business with the City. The form requests information regarding beneficial ownership and control by individuals who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer; current LGBTBE certification status through the National LGBT Chamber of Commerce (NGLCC) or its Philadelphia affiliate, the Independence Business Alliance (IBA); additional third-party certifications held by the applicant business; and identification of any LGBTQ-certified subcontractors involved in the specific contracting opportunity. The form specifically relates to a Barber Supplies micro purchase opportunity to be awarded to the lowest responsive and responsible bidder, with sellers required to quote all items to be eligible for award.
The data collected through this form is voluntary and submitted with the understanding that the City may use the information for other projects and may make the data publicly available at its discretion. The form does not establish pricing terms, set-asides, or funding requirements but rather serves as a data collection mechanism to support the City's vendor database development and future supplier diversity efforts. Completion of the form does not affect bid evaluation or award criteria; rather, it supports the City's broader commitment to identifying and potentially increasing opportunities for LGBTQ-owned businesses in its procurement activities.
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Other files
| File | Type | Posted |
|---|---|---|
| Micro Purchase Terms and Conditions FY26~39.pdf | ||
| Contracts Consent Agreement~39.pdf | ||
| Small Purchase Checklist~81.pdf |
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Text version
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 of Philadelphia’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.
By submitting this form you are agreeing that the City may, in its discretion, use the data submitted for other projects and may cause it to become publicly available.
Response to this form is entirely voluntary.
Applicant Name:
Bid or Opportunity #:
LGBTQ Applicant Opportunity DataLGBTQ Applicant Opportunity Data
CCIITTY Y OF OF PHIPHILALADDELPHELPHIIA
1401 JFJFK K BBllvvdd. . RoRooom m 117700B B - - PhPhiillaaddeellpphhiiaa, , PA PA 1199110022--11668855 www.phila.gov/procurement
| 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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