LGBTQ Applicant Data Form B2627119.pdf
PDF 2 MB Posted
- Attached to
- FLASH DRIVE State and local contract opportunity
- Solicitation number
- B2627119
- 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 B2627119. The form is designed to collect demographic and certification information from businesses seeking to participate in City procurement processes. The associated micro-purchase contract opportunity involves Flash Drive supplies with a requirements period from May 12, 2026 through June 30, 2026. The City will award the contract as a whole or by line item, whichever serves the City's best interests, to the lowest responsive and responsible bidder. All items must be quoted for a vendor to be eligible for award, and vendors are instructed not to deliver or provide services until notified by the department.
The form is entirely voluntary and serves the City of Philadelphia's commitment to diversity, equity, and inclusion in procurement. It requests information regarding whether applicants are beneficially owned and controlled by LGBTQ persons, current certification status with the National LGBT Chamber of Commerce through the Independence Business Alliance, certifications from other third-party agencies such as ESMDC, PAUCP, Disability:IN, or WBENC, and identification of any LGBTQ-certified subcontractors. The City intends to use the collected data to identify LGBTQ businesses currently doing business with the City and to expand inclusion of LGBTQ-certified businesses in the City's vendor database. Data submitted may be used for other projects and may become publicly available at the City's discretion.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| PHL-Contracts-Consent_Authorization B2627119.pdf | ||
| Seller SOP Checklist B2627119.pdf | ||
| Micro Purchase Terms and Conditions FY26 B2627119.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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