LGBTQ_Applicant_Data_Form_B2627316.pdf
PDF 2 MB Posted
- Attached to
- Craft Kits State and local contract opportunity
- Solicitation number
- B2627316
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form from the City of Philadelphia's Procurement Department designed to collect information about businesses beneficially owned and controlled by individuals who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer. The form requires applicants to disclose whether their business is certified as an LGBTBE by the National LGBT Chamber of Commerce (NGLCC) through its Philadelphia affiliate, the Independence Business Alliance (IBA), or by 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). Additionally, applicants must identify any subcontractors that hold LGBTBE certification. Submission of this form is entirely voluntary, and applicants acknowledge that the City may use the submitted data for other projects and may make it publicly available.
The City of Philadelphia is collecting this data as part of its commitment to diversity, equity, and inclusion in procurement to identify the number of LGBTQ-owned businesses currently doing business with the City and to facilitate the inclusion of LGBTQ-certified businesses in the City's vendor database. This form applies to the Craft Kits micro-purchase opportunity in Pennsylvania, which will be awarded as a whole to the lowest responsive and responsible bidder. Sellers must quote all items to be eligible for award, and this is structured as a Requirements contract. No delivery or services should commence until notification is received from the department.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| MP_Terms_and_Conditions_B2627316.pdf | ||
| Consent_Authorization_B2627316.pdf | ||
| Seller_SOP_Checklist_B2627316.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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