LGBTQ Applicant Data Form B2627077.pdf

PDF 2 MB Posted

Attached to
CWR IT Equipment State and local contract opportunity
Solicitation number
B2627077
Issued by
Pennsylvania

About this file

This is an LGBTQ Applicant Opportunity Data Form related to a micro purchase IT equipment contract opportunity in Pennsylvania administered by the City. The form is designed to collect voluntary demographic information from applicants regarding lesbian, gay, bisexual, transgender, and queer (LGBTQ) business ownership and certification status. 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. Applicants must quote all items to be eligible for award and should not deliver services or equipment until receiving formal notification from the department.

The City is collecting this data to identify LGBTQ businesses currently conducting or seeking to conduct business with the municipality and to facilitate inclusion of LGBTQ-certified vendors in the City's vendor database. The form requests information regarding beneficial ownership and control by LGBTQ persons, current certification status through the National LGBT Chamber of Commerce (NGLCC) or its Philadelphia affiliate, the Independence Business Alliance (IBA), additional third-party certifications such as those from the Eastern Minority Supplier Development Council or Women's Business Enterprise National Council, and the involvement of LGBTQ-certified subcontractors. Response to the data collection form is entirely voluntary and does not impact bid eligibility or award decisions.

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Other files for this state and local contract opportunity

Other files attached to CWR IT Equipment, newest first.
File Type Posted
PHL-Contracts-Consent_Authorization B2627077.pdf PDF
Micro Purchase Terms and Conditions B2627077.pdf PDF
Seller Checklist - Small Purchases B2627077.pdf 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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