LGBTQ_Applicant_Data_Form_B2727634.pdf
PDF 2 MB Posted
- Attached to
- Pallet Rack Framing
- Solicitation number
- B2727634
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form utilized by the City of Philadelphia's Procurement Department to collect demographic information from vendors seeking to conduct business with the municipality. The form requests applicants to identify whether their businesses are beneficially owned and controlled by individuals who self-identify as Lesbian, Gay, Bisexual, Transgender, or Queer. The document serves as a voluntary data collection instrument designed to support the City's commitment to diversity, equity, and inclusion in municipal procurement processes. Applicants are asked to provide their business name and the relevant bid or opportunity number, with responses to all inquiries being entirely optional. The City of Philadelphia reserves the right to utilize submitted data for other projects and may make such information publicly available at its discretion.
The form specifically inquires about LGBTBE certification status through the National LGBT Chamber of Commerce (NGLCC) and its local Philadelphia affiliate, the Independence Business Alliance (IBA). Applicants must also disclose any additional third-party certifications from agencies such as the Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN, or the Women's Business Enterprise National Council (WBENC), along with the corresponding certification categories (MBE, WBE, DSBE, DBE). The form requests identification of any LGBTBE-certified subcontractors being utilized on the specific contracting opportunity. This data collection effort is intended to identify the number of LGBTQ-owned businesses currently engaged with the City and to facilitate the inclusion of LGBTQ-certified enterprises into the City's vendor database for future procurement opportunities.
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Other files
| File | Type | Posted |
|---|---|---|
| MP_Terms_and_Conditions_B2727634.pdf | ||
| Seller_SP_Checklist_B2727634.pdf | ||
| Consent_Authorization_B2727634.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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