LGBTQ_Applicant_Data_Form_B2626991.pdf
PDF 612 KB Posted
- Attached to
- Heavy Duty Shelving
- Solicitation number
- B2626991
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Opportunity Data Form associated with a heavy duty shelving micro purchase opportunity in Pennsylvania. The form collects voluntary demographic information from applicants to identify companies beneficially owned and controlled by Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) persons interested in conducting business with the City. The data gathering effort supports the City's commitment to diversity, equity, and inclusion in municipal procurement and will be used to develop the City's vendor database with certified LGBTQ businesses. The associated contract opportunity requires the awarded vendor to provide delivery and full on-site assembly of shelf units, with all costs included in the submitted quote. Vendors must quote all items to be eligible for award, and the micro purchase will be awarded as a whole or by line item, whichever serves the City's best interests, to the lowest responsive and responsible bidder.
The form requests information regarding LGBTQ business certification status through the National LGBT Chamber of Commerce (NGLCC) via the Philadelphia-based Independence Business Alliance (IBA), as well as any additional third-party certifications such as MBE, WBE, DSBE, or DBE designations from agencies including 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 being utilized on the contract. Vendors are instructed not to deliver or provide services until notified by the department.
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Other files
| File | Type | Posted |
|---|---|---|
| Seller Checklist _ B2626991.pdf | ||
| Specifications_B2626991.pdf | ||
| Consent_Authorization_ B2626991.pdf | ||
| Micro Purchase Terms and Conditions_B2626991.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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