LGBTQ_Applicant_Data_Form_B2627175.pdf
PDF 2 MB Posted
- Attached to
- City and US Flags
- Solicitation number
- B2627175
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form issued by the City of Philadelphia's Procurement Department in connection with a small order purchase for City and US Flags in Pennsylvania. The form is designed to collect voluntary demographic data from applicants regarding LGBTQ business ownership and certification status as part of the City's commitment to diversity, equity, and inclusion in procurement activities. The questionnaire requests information on whether the applicant's business is beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer, and whether the business holds current LGBTBE certification through the National LGBT Chamber of Commerce (NGLCC) via the Philadelphia-based Independence Business Alliance (IBA). Additionally, applicants are asked to disclose any LGBTBE-certified subcontractors participating in the bid.
The form serves an informational purpose rather than establishing contract terms or pricing requirements. Submission of the LGBTQ Applicant Data Form is entirely voluntary, and applicants acknowledge that the City may use the submitted data for other projects and may make it publicly available in its discretion. The data collected will be used to identify the number of LGBTQ-owned businesses currently doing business with the City and to facilitate inclusion of LGBTQ certified businesses into the City's vendor database. This is a small order purchase to be awarded as a whole or by line item, whichever serves the City's best interest, to the lowest responsive and responsible bidder.
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Other files
| File | Type | Posted |
|---|---|---|
| MP_Terms_and_Conditions_FY26_B2627175.pdf | ||
| Seller_SP_Checklist_B2627175.pdf | ||
| Consent_Authorization_B2627175.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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