LGBTQ_Applicant_Data_Form_B2727449.pdf
PDF 2 MB Posted
- Attached to
- Mini Blinds
- Solicitation number
- B2727449
- Issued by
- Pennsylvania
About this file
LGBTQ Applicant Data Form for Mini Blinds Micro Purchase
This is an LGBTQ Applicant Data Form related to a micro purchase for mini blinds issued by a Pennsylvania municipality. The procurement is structured as a competitive bidding opportunity that will be awarded as a whole or by line item, whichever serves the best interest of the City, to the lowest responsive and responsible bidder. Prospective sellers must quote all items included in the solicitation to be eligible for award consideration. Bidders are instructed not to deliver products or provide services until receiving formal notification from the department, and this is designated as a requirement bid, meaning all specifications must be met.
The form functions as a data collection document for applicants to self-identify their LGBTQ business status for purposes of tracking and potentially qualifying for any applicable diversity or inclusion programs associated with the procurement. The specific pricing terms, item quantities, due dates, and other detailed bid requirements would be contained in the primary solicitation documents rather than in this demographic form. Bidders should refer to the complete scope of work and bidding instructions for all substantive procurement details including pricing, delivery requirements, and award criteria.
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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 .