LGBTQ_Applicant_Data_Form_B2727501.pdf
PDF 2 MB Posted
- Attached to
- Shelving
- Solicitation number
- B2727501
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form associated with the City of Philadelphia's shelving micro purchase opportunity in Pennsylvania. The form is designed to collect voluntary demographic data from applicants regarding LGBTQ business ownership and certification status to support the City's diversity, equity, and inclusion procurement initiatives. Applicants are asked to indicate whether their business is beneficially owned and controlled by individuals who self-identify as lesbian, gay, bisexual, transgender, or queer, and whether they hold current LGBTBE certification through the National LGBT Chamber of Commerce (NGLCC) via its local Philadelphia affiliate, the Independence Business Alliance (IBA). The form also requests information about any additional third-party certifications from agencies such as ESMDC, PAUCP, Disability:IN, or WBENC, as well as identification of any certified LGBTQ subcontractors involved in the project.
The data collected through this form is intended to build the City's vendor database and identify LGBTQ-owned businesses currently engaged with municipal procurement. Submission of the form is entirely voluntary, and applicants grant the City discretionary authority to use the submitted data for other projects and to make it publicly available as deemed appropriate. The micro purchase will be awarded to the lowest responsive and responsible bidder, either as a whole or by line item based on the City's determination of best interest, with the requirement that sellers quote all items to be eligible for award.
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Other files
| File | Type | Posted |
|---|---|---|
| Seller_SP_Checklist_B2727501.pdf | ||
| Consent_Authorization_B2727501.pdf | ||
| MP_Terms_and_Conditions_B2727501.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 .