LGBTQ_Applicant_Data_Form_ B2627163.pdf
PDF 665 KB Posted
- Attached to
- TelVue Care One Year extension.
- Solicitation number
- B2627163
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Opportunity Data Form used by the City of Philadelphia in Pennsylvania for diversity, equity, and inclusion procurement purposes. The form collects voluntary information from applicants regarding LGBTQ business ownership and certification status to identify and track the number of LGBTQ-owned businesses engaging with the City. The form requests three primary data points: whether the applicant's business is beneficially owned and controlled by individuals who self-identify as lesbian, gay, bisexual, transgender, or queer; current certification status as an LGBTBE through the National LGBT Chamber of Commerce (NGLCC) via the Philadelphia-based Independence Business Alliance (IBA); and information regarding any LGBTBE-certified subcontractors being utilized on the contract opportunity.
The form additionally inquires whether applicants hold certifications from other third-party certifying agencies such as the Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN, or Women's Business Enterprise National Council (WBENC). The data collected through this form is intended to support the City's efforts to expand the vendor database to include LGBTQ-certified businesses and to measure the current participation of LGBTQ-owned enterprises in City procurement activities. Response to the form is completely voluntary and carries no bearing on bid evaluation or contract award decisions. This particular form corresponds to the TelVue Care One Year extension contract opportunity, which will be awarded as a whole or by line item, at the City's discretion, to the lowest responsive and responsible bidder.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| MP_Terms_and_Conditions_B2627163.pdf | ||
| Sole Source Statement Telvue 2026~1.pdf | ||
| Consent_Authorization_ B2627163.pdf | ||
| Q-019183 maintenance.pdf | ||
| Sole Product request - Telvue care warranty~1.docx | DOCX document | |
| Seller_SP_Checklist_B2627163.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 #
Y N
Y N
Y N
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