LGBTQ_Applicant_Data_Form_B2727369.pdf
PDF 2 MB Posted
- Attached to
- Three Screen Led Wall Package State and local contract opportunity
- Solicitation number
- B2727369
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form related to a Pennsylvania state and local contract opportunity for a Three Screen Led Wall Package. The form serves as a certification document for applicants to indicate their LGBTQ business status in connection with the bidding process. The contract opportunity itself is structured as a small order purchase awarded to the lowest responsive and responsible bidder, with a requirement that sellers quote all items to be eligible for award. No delivery or provision of services is permitted until formal notification by the department. This procurement will result in a requirements contract, establishing an ongoing relationship between the selected vendor and the purchasing entity.
The form functions as a self-certification mechanism to track diversity participation and may influence evaluation criteria or set-asides within the competitive bidding process. Bidders are required to complete this form to demonstrate their LGBTQ business ownership status. The specific pricing terms, quantities of the three LED screens, delivery schedules, and contract duration details would be contained in the associated bid solicitation documents. All interested vendors must comply with submission requirements and provide complete quotes covering all specified items to remain eligible for consideration and potential award.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| SOP_Terms_and_Conditions_B2727369~1.pdf | ||
| Consent_Authorization_B2727369.pdf | ||
| SOP_Terms_and_Conditions_B2727369.pdf | ||
| Seller_SOP_Checklist_B2727369.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: |
File details come from the government source that posted it. Updated .