LGBTQ_Applicant_Data_Form_B2627025.pdf
PDF 2 MB Posted
- Attached to
- Body Cameras State and local contract opportunity
- Solicitation number
- B2627025
- 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 B2627025, related to a Body Cameras micro purchase. The form serves as a voluntary data collection instrument designed to identify businesses beneficially owned and controlled by Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) persons seeking to conduct business with the City. The document requests applicants to identify their LGBTQ business ownership status, current certification as an LGBTBE through the National LGBT Chamber of Commerce (NGLCC) or its Philadelphia affiliate the Independence Business Alliance (IBA), and any additional third-party certifications held by the applicant such as those from ESMDC, PAUCP, Disability:IN, or WBENC. Additionally, applicants are required to disclose whether any subcontractors are LGBTBE certified and, if so, to list them by business name.
The City of Philadelphia has indicated that the data collected through this form may be used at the City's discretion for other projects and may be made publicly available as part of the City's commitment to diversity, equity, and inclusion in procurement practices. The micro purchase for body cameras will be awarded as a whole or by line item, whichever serves the City's best interest, to the lowest responsive and responsible bidder, with the requirement that sellers quote all items to be eligible for award. The resulting contract will be structured as a Requirements contract. Submission of this form is entirely voluntary, and no delivery or services should commence until formal notification is provided by the department.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| MP_Terms_and_Conditions_B2627025.pdf | ||
| Seller_SOP_Checklist_B2627025.pdf | ||
| Consent_Authorization_B2627025.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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