LGBTQ Applicant Data Form B2627148.pdf
PDF 2 MB Posted
- Attached to
- HORSE STALL KITS/BARN SUPPLIIES
- Solicitation number
- B2627148
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form issued by the City of Philadelphia's Office of Procurement as part of the procurement process for a Horse Stall Kits/Barn Supplies micro purchase opportunity in Pennsylvania. 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 micro purchase will be awarded as a whole or by line item, whichever serves the City's best interest, to the lowest responsive and responsible bidder. Applicants must quote all items to be eligible for award, and the contract performance period runs from May 15, 2026, through June 30, 2026. Vendors are instructed not to deliver or provide services until receiving formal notification from the department.
The form collects information regarding applicant certification status, including whether the applicant's business is currently certified as an LGBTBE by the National LGBT Chamber of Commerce (NGLCC) through the Philadelphia affiliate Independence Business Alliance (IBA), or by other third-party certifying agencies such as ESMDC, PAUCP, Disability:IN, or WBENC. The form also inquires whether any subcontractors are LGBTBE-certified through NGLCC/IBA. The City of Philadelphia indicates that submitted data may be used discretionarily for other projects and may become publicly available, with the stated objective of expanding LGBTQ business inclusion in the City's vendor database and supporting the City's commitment to diversity, equity, and inclusion in public procurement.
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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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