LGBTQ_Applicant_Data_Form_B1801234~21.pdf
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- Hand Tools
- Solicitation number
- B2626809
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Opportunity Data Form used by the City of Philadelphia to collect diversity and inclusion information from businesses seeking to contract with the municipality. The form is designed to identify companies beneficially owned and controlled by individuals who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer (LGBTQ). The document requests applicant identification information including business name and bid or opportunity number, along with information regarding current LGBTBE certification status through the National LGBT Chamber of Commerce (NGLCC) and its local Philadelphia affiliate, the Independence Business Alliance (IBA).
The form collects data on whether applicants hold LGBTBE certification, 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), and details on NGLCC/IBA-certified subcontractors being utilized for the contract opportunity. Participation in this data collection is voluntary and serves to build the City's vendor database while supporting its commitment to diversity, equity, and inclusion in procurement activities. The form does not establish pricing terms, set-asides, or specific contract requirements but rather functions as a supplementary documentation tool to gather demographic and certification information from prospective contractors.
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Other files
| File | Type | Posted |
|---|---|---|
| MP_Terms_and_Conditions_B1801234~13.pdf | ||
| Seller_SP_Checklist_B1801234~17.pdf | ||
| Consent_Authorization_B1801234~23.pdf |
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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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