LGBTQ_Applicant_Data_Form B2626631.pdf
PDF 2 MB Posted
- Attached to
- BV ASP REQ 2026
- Solicitation number
- B2626631
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form (B2626631) issued by the City of Philadelphia's Procurement Department as part of the city's commitment to diversity, equity, and inclusion in public procurement. The form is designed to collect voluntary data from applicants and bidders regarding LGBTQ business ownership and certification status for the contract opportunity BV ASP REQ 2026. The form requests information about whether applicants' businesses are beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer, and whether they hold current certification as an LGBTBE through the National LGBT Chamber of Commerce (NGLCC) via the Philadelphia affiliate Independence Business Alliance (IBA). Additionally, the form inquires whether applicants have LGBTQ-certified subcontractors participating in the bid.
The form collects optional demographic and certification data that the City of Philadelphia may use to populate its vendor database and analyze LGBTQ business participation in city procurement activities. Respondents are asked to identify any third-party certifications held by their business through agencies such as the Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN, or the Women's Business Enterprise National Council (WBENC), along with the corresponding certification category. Applicants may also list the names of any LGBTQ-certified subcontractors included in their bid. The city reserves the right to use the submitted data for other projects and to make it publicly available. Submission of the form is entirely voluntary and does not affect bid eligibility or award determination for the underlying micro purchase opportunity.
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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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