LGBTQ Applicant Data Form B2626798.pdf
PDF 2 MB Posted
- Attached to
- COMMENDATION SUPPLIES
- Solicitation number
- B2626798
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form issued by the City of Philadelphia's procurement department for contract opportunity B2626798. The form collects voluntary demographic information from applicants regarding LGBTQ business ownership and certification status. The document requests applicants to identify whether their business is beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer, and whether the business holds current certification as an LGBTBE through the National LGBT Chamber of Commerce (NGLCC) via its Philadelphia affiliate, the Independence Business Alliance (IBA). The form also requests information about any additional third-party certifications held by the applicant, such as MBE, WBE, DSBE, or DBE designations from agencies including the Eastern Minority Supplier Development Council, Pennsylvania Unified Certification Program, Disability:IN, or Women's Business Enterprise National Council.
The data collected through this form is intended to assist the City of Philadelphia in identifying LGBTQ-owned businesses interested in conducting business with the municipality and to facilitate inclusion of LGBTQ certified businesses into the City's vendor database. Applicants are informed that submission of the form constitutes agreement allowing the City to use the submitted data at its discretion for other projects and potentially make it publicly available. The form also requests identification of any subcontractors certified as LGBTBEs by NGLCC/IBA. Response to this form is entirely voluntary, and it serves as a diversity, equity, and inclusion initiative within the City's procurement processes.
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Other files
| File | Type | Posted |
|---|---|---|
| Seller SOP Checklist B2626798.pdf | ||
| Current Seal.jpeg | JPEG file | |
| Micro Purchase Terms and Conditions FY26 B2626798.pdf | ||
| PHL-Contracts-Consent_Authorization B2626798.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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