LGBTQ Applicant Data Form B2627292.pdf
PDF 2 MB Posted
- Attached to
- Emergency Transportation - OEM
- Solicitation number
- B2627292
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form associated with a Pennsylvania small order purchase for Emergency Transportation services under the Office of Emergency Management (OEM). The form is designed to collect diversity information from bidders participating in this procurement opportunity. The City of Pennsylvania reserves the right to award the contract as a whole or by individual line items, whichever serves the City's best interests, to the lowest responsive and responsible bidder. All bidders must quote all items to be considered eligible for award, and services or delivery must not commence until formal notification is received from the contracting department.
The form functions as a self-identification mechanism for LGBTQ-owned businesses and serves to track applicant diversity metrics for the procurement process. This data collection supports the City's commitment to inclusive procurement practices and may be used to monitor participation of LGBTQ-owned enterprises in government contracting. Completion of the diversity form does not affect bidding eligibility or evaluation criteria; rather, it enables the City to assess the diversity of its supplier base and track progress toward diversity goals in emergency services procurement.
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Other files
| File | Type | Posted |
|---|---|---|
| SOP Terms and Conditions B2627292.pdf | ||
| Transportation Contract Scope - SOP~1.docx | DOCX document | |
| PHL-Contracts-Consent_Authorization B2627292.pdf | ||
| Seller Checklist - Small Purchases B2627292.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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