LGBTQ_Applicant_Data_Form_B1801234~26.pdf
PDF 2 MB Posted
- Attached to
- Infrared Themometer
- Solicitation number
- B2727927
- 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 bidders on state and local contract opportunities in Pennsylvania. The form serves as a voluntary data collection instrument designed to identify companies beneficially owned and controlled by Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) persons seeking to conduct business with the City. The specific contract opportunity associated with this form is a micro purchase for infrared thermometers to be awarded as a whole or by line item, whichever best serves the City's interests, to the lowest responsive and responsible bidder. Applicants must quote all items to be eligible for award consideration, and no delivery or services may commence until formal notification is received from the purchasing department.
The form collects data regarding LGBTQ business certification status, including whether applicants hold certification from the National LGBT Chamber of Commerce (NGLCC) through their Philadelphia affiliate, the Independence Business Alliance (IBA), or from other third-party certifying 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). Applicants are also asked to identify any LGBTQ-certified subcontractors participating in the contract opportunity. The City intends to utilize this collected data to enhance its vendor database, identify LGBTQ-owned businesses currently conducting business with the City, and support broader diversity, equity, and inclusion objectives in municipal procurement practices.
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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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